Unexpected case of aplastic anemia in a patient with glioblastoma multiforme treated with Temozolomide.
We report the case of a 30-year-old woman with glioblastoma multiforme (GBM) treated with surgery followed by concomitant Temozolomide (TMZ) and external beam radiation, which she tolerated well without any interruptions. However, when she was being evaluated for adjuvant Temozolomide, she developed progressive decline in leukocyte counts and platelet counts and subsequently, febrile neutropenia with bleeding manifestations. A bone marrow aspiration and biopsy done showed a gross hypocellular bone marrow with very few erythriod and myeloid cells and no suggestion of progenitor cells, consistent with aplastic anemia.
Jalali
Rakesh
R
Department of Radiation Oncology, 116 Tata Memorial Hospital, Parel, Mumbai 400 012, India. rjalali@medscape.com
Singh
Pritanjali
P
Menon
Hari
H
Gujral
Sumeet
S
D000328:Adult; D000741:Anemia, Aplastic / Q000139:chemically induced*; D018906:Antineoplastic Agents, Alkylating / Q000009:adverse effects* / Q000627:therapeutic use*; D001772:Blood Cell Count; D001853:Bone Marrow / Q000473:pathology; D001932:Brain Neoplasms / Q000150:complications* / Q000188:drug therapy* / Q000532:radiotherapy; D003131:Combined Modality Therapy; D003606:Dacarbazine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D017809:Fatal Outcome; D005260:Female; D005909:Glioblastoma / Q000150:complications* / Q000188:drug therapy* / Q000532:radiotherapy; D006801:Humans; D008279:Magnetic Resonance Imaging; D010198:Pancytopenia / Q000097:blood / Q000139:chemically induced; D018805:Sepsis / Q000150:complications; D000077204:Temozolomide
D018906:Antineoplastic Agents, Alkylating; D003606:Dacarbazine; D000077204:Temozolomide