Treatment-related myelodysplastic syndrome after temozolomide for recurrent high-grade glioma

J Neurooncol. 2005 Feb;71(3):315-8. doi: 10.1007/s11060-004-2028-0.

Abstract

In patients with recurrent malignant glioma, treatment-related myelodysplastic syndrome (t-MDS) and acute leukemia are rare adverse effects because the median survival after relapse is limited. We report a 44-year-old woman with t-MDS (refractory anemia with excess blasts) following treatment of recurrent anaplastic astrocytoma with temozolomide (TMZ). A cytogenetic study showed del (3)(q11.1). MDS was diagnosed 8.4 months after beginning TMZ. The disease rapidly evolved into acute leukemia within 1 month after the onset of MDS, and the patient died 1 month later during induction chemotherapy. The prognosis of t-MDS is generally poor. Considering the increasing use of TMZ, which is regarded as a drug with moderate toxicity, careful follow-up with routine blood testing is vital.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Acute Disease
  • Adult
  • Antineoplastic Agents, Alkylating / adverse effects*
  • Antineoplastic Agents, Alkylating / therapeutic use
  • Astrocytoma / drug therapy*
  • Astrocytoma / genetics
  • Astrocytoma / surgery
  • Brain Neoplasms / drug therapy*
  • Brain Neoplasms / genetics
  • Brain Neoplasms / surgery
  • Chromosomes, Human, Pair 11
  • Dacarbazine / adverse effects*
  • Dacarbazine / analogs & derivatives*
  • Dacarbazine / therapeutic use
  • Fatal Outcome
  • Female
  • Gene Deletion
  • Humans
  • Leukemia / chemically induced*
  • Leukemia / drug therapy
  • Leukemia / genetics
  • Myelodysplastic Syndromes / chemically induced*
  • Myelodysplastic Syndromes / diagnosis
  • Myelodysplastic Syndromes / genetics
  • Neoplasm Recurrence, Local / drug therapy*
  • Neoplasm Recurrence, Local / genetics
  • Neoplasm Recurrence, Local / surgery
  • Temozolomide

Substances

  • Antineoplastic Agents, Alkylating
  • Dacarbazine
  • Temozolomide