title: Inadvertent high-dose therapy with temozolomide in a child with recurrent pontine glioma followed by a rapid clinical response but deteriorated after substitution with low-dose therapy.
abstract: We present a case of inadvertent high-dose therapy with temozolomide in a child with recurrent diffuse intrinsic pontine glioma followed by a rapid clinical response. The patient was a 7-year-old boy who initially presented with a history of left facial palsy, double vision, headache, and ataxia. His symptoms were completely resolved following radiotherapy but recurred 3 months after. Following recurrence, he received temozolomide in a dose >3 times higher than prescribed inadvertently but tolerated well with a rapid clinical response. He eventually deteriorated after he was substituted with a lower dose of temozolomide and died.
authors.affiliation: *Division of Hematology/Oncology †Department of Radiology ‡Department of Neurosurgery §Gershenson Radiation Oncology Center ∥Department of Pathology, Children's Hospital of Michigan, Detroit, MI.
authors.forename: Zhihong J
authors.initials: ZJ
authors.lastname: Wang
authors.forename: Deniz
authors.initials: D
authors.lastname: Altonok
authors.forename: Sandeep
authors.initials: S
authors.lastname: Sood
authors.forename: Andre
authors.initials: A
authors.lastname: Konski
authors.forename: Janet
authors.initials: J
authors.lastname: Poulik
mesh_terms: D018906:Antineoplastic Agents, Alkylating / Q000008:administration & dosage*; D020295:Brain Stem Neoplasms / Q000188:drug therapy* / Q000473:pathology; D002648:Child; D003606:Dacarbazine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D004305:Dose-Response Relationship, Drug; D017809:Fatal Outcome; D005910:Glioma / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy* / Q000473:pathology; D000077204:Temozolomide
chemical_list: D018906:Antineoplastic Agents, Alkylating; D003606:Dacarbazine; D000077204:Temozolomide