title: Treatment-related myelodysplastic syndrome after temozolomide for recurrent high-grade glioma.
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.
authors.affiliation: Department of Hematology-Oncology, Mackay Memorial Hospital, Taiwan. yingwen_su@yahoo.com.tw
authors.forename: Ying-Wen
authors.initials: YW
authors.lastname: Su
authors.forename: Ming-Chih
authors.initials: MC
authors.lastname: Chang
authors.forename: Ming-Fu
authors.initials: MF
authors.lastname: Chiang
authors.forename: Ruey-Kuen
authors.initials: RK
authors.lastname: Hsieh
mesh_terms: D000208:Acute Disease; D000328:Adult; D018906:Antineoplastic Agents, Alkylating / Q000009:adverse effects* / Q000627:therapeutic use; D001254:Astrocytoma / Q000188:drug therapy* / Q000235:genetics / Q000601:surgery; D001932:Brain Neoplasms / Q000188:drug therapy* / Q000235:genetics / Q000601:surgery; D002880:Chromosomes, Human, Pair 11; D003606:Dacarbazine / Q000009:adverse effects* / Q000031:analogs & derivatives* / Q000627:therapeutic use; D017809:Fatal Outcome; D005260:Female; D017353:Gene Deletion; D006801:Humans; D007938:Leukemia / Q000139:chemically induced* / Q000188:drug therapy / Q000235:genetics; D009190:Myelodysplastic Syndromes / Q000139:chemically induced* / Q000175:diagnosis / Q000235:genetics; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy* / Q000235:genetics / Q000601:surgery; D000077204:Temozolomide
chemical_list: D018906:Antineoplastic Agents, Alkylating; D003606:Dacarbazine; D000077204:Temozolomide
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