Treatment-related myelodysplastic syndrome after temozolomide for recurrent high-grade glioma.
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.
Su
Ying-Wen
YW
Department of Hematology-Oncology, Mackay Memorial Hospital, Taiwan. yingwen_su@yahoo.com.tw
Chang
Ming-Chih
MC
Chiang
Ming-Fu
MF
Hsieh
Ruey-Kuen
RK
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
D018906:Antineoplastic Agents, Alkylating; D003606:Dacarbazine; D000077204:Temozolomide
J Clin Oncol. 1998 Mar;16(3):1008-12
9508184
Cancer Res. 1992 May 1;52(9):2419-23
1568211
Cancer Res. 2001 Apr 15;61(8):3439-42
11309305
Semin Oncol. 2001 Aug;28(4 Suppl 13):3-12
11550133
Eur J Cancer. 1991;27(4):427-30
1851618
Pediatr Hematol Oncol. 1991 Jan-Mar;8(1):77-82
2029469
Leukemia. 2002 Jan;16(1):1-6
11840256
N Engl J Med. 1985 Aug 29;313(9):579
3894973
Neurosurgery. 1982 Sep;11(3):408-11
6290930
N Engl J Med. 1986 Jan 9;314(2):119-20
3941685
Nature. 1998 Dec 17;396(6712):643-9
9872311
J Clin Oncol. 1999 Sep;17 (9):2762-71
10561351
J Dermatol. 2000 Mar;27(3):178-80
10774145
Lancet. 1997 Feb 1;349(9048):344-9
9024390
JAMA. 1990 Aug 22-29;264(8):1006-8
2376872
J Neurosurg. 1984 Jun;60(6):1287-90
6327940
Hum Pathol. 1999 Jul;30(7):868-71
10414508
Hematol Oncol Clin North Am. 1996 Apr;10(2):293-320
8707757
Cancer. 1983 Jul 15;52(2):222-6
6861068
BMJ. 1990 Nov 10;301(6760):1077-80
2249071
Blood. 1981 Oct;58(4):759-67
7272506
J Neurooncol. 1998 Oct;40(1):39-46
9874184
J Clin Oncol. 1999 Aug;17(8):2572-8
10561324
J Clin Oncol. 2002 Mar 1;20(5):1375-82
11870182
J Clin Oncol. 1986 Dec;4(12):1748-57
3783201
Genes Chromosomes Cancer. 1996 Jul;16(3):155-63
8814447
Ann Oncol. 2003 Apr;14 (4):599-602
12649108
Br J Cancer. 2000 Sep;83(5):588-93
10944597
Leuk Lymphoma. 2002 Jun;43(6):1267-71
12152995
Arch Neurol. 1982 Oct;39(10):664-5
7125981
Semin Oncol. 2000 Jun;27(3 Suppl 6):27-34
10866347
Am J Pathol. 2000 Feb;156(2):651-9
10666394
N Engl J Med. 1992 Jun 25;326(26):1745-51
1594016