title: Evaluation of temozolomide in patients with myelodysplastic syndrome.
abstract: In our previous phase I study of temozolomide in patients with acute leukemia, temozolomide was well tolerated and demonstrated significant anti-leukemic activity. The maximum tolerated dose was 200 mg/m2/d for 7 days, repeated approximately every 5-6 weeks. In the current study, we evaluated the same dose of temozolomide in patients with myelodysplastic syndrome. Fourteen patients received 19 courses of temozolomide. The median age was 71 years. In this study, treatment was poorly tolerated with patients requiring admission in 9 of 19 courses. Toxicity included worsening cytopenias, neutropenic fever, and exacerbation of cardiac disease, the latter due to worsening anemia. An unusual finding was the development of leukocytoclastic vasculitis in 4 patients. There were no formal responses to therapy. The current schedule of temozolomide is not efficacious in patients with myelodysplastic syndrome.
authors.affiliation: Zalmen A. Arlin Cancer Institute, Department of Medicine, New York Medical College, Valhalla, New York, USA. karen_Seiter@nymc.edu
authors.forename: Karen
authors.initials: K
authors.lastname: Seiter
authors.forename: Delong
authors.initials: D
authors.lastname: Liu
authors.forename: Ahmad D
authors.initials: AD
authors.lastname: Siddiqui
authors.forename: Robert
authors.initials: R
authors.lastname: Lerner
authors.forename: John
authors.initials: J
authors.lastname: Nelson
authors.forename: Tauseef
authors.initials: T
authors.lastname: Ahmed
mesh_terms: D000368:Aged; D000740:Anemia / Q000139:chemically induced; D018906:Antineoplastic Agents, Alkylating / Q000009:adverse effects*; D009202:Cardiomyopathies / Q000139:chemically induced; D003606:Dacarbazine / Q000009:adverse effects* / Q000031:analogs & derivatives*; D004341:Drug Evaluation; D005260:Female; D005334:Fever / Q000139:chemically induced; D006801:Humans; D008297:Male; D020714:Maximum Tolerated Dose; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000188:drug therapy*; D009503:Neutropenia / Q000139:chemically induced; D000077204:Temozolomide; D017211:Treatment Failure
chemical_list: D018906:Antineoplastic Agents, Alkylating; D003606:Dacarbazine; D000077204:Temozolomide