A Case of Therapy-Related Acute Myeloid Leukemia Associated with Adjuvant Temozolomide Chemotherapy for Anaplastic Astrocytoma

Kenzo Kosugi, Katsuya Saito, Wataru Takahashi, Yukina Tokuda, Hideyuki Tomita

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)

Abstract

Background Temozolomide (TMZ) is now standard adjuvant therapy in combination with radiotherapy for patients with newly diagnosed malignant glioma. Treatment-related myelodysplastic syndrome and acute treatment-related leukemia (t-AML) associated with TMZ chemotherapy for patients with glioma is quite a rare complication. Case Description A 43-year-old man with an anaplastic astrocytoma received radiation therapy synchronized with ranimustine and adjuvant TMZ chemotherapy for 15 cycles. Close follow-up magnetic resonance imaging of the head during TMZ chemotherapy showed no evidence of tumor progression. One year after the completion of TMZ chemotherapy, a bone-marrow aspiration was performed because the patient's white blood cell count decreased. He was diagnosed with t-AML based on the bone marrow examination, and then he was referred to the cancer center for the treatment of t-AML. Conclusions In this case study, we continued adjuvant TMZ therapy beyond the recommended 6 cycles. Currently, there is no consensus as to how long the adjuvant TMZ therapy should be continued for the treatment of residual tumor showing no apparent interval change. A new decision-making tool to assess the clinical benefits against the side effects for long-term adjuvant TMZ therapy is needed.

Original languageEnglish
Pages (from-to)816.e11-816.e16
JournalWorld Neurosurgery
Volume101
DOIs
Publication statusPublished - 2017 May 1
Externally publishedYes

Keywords

  • Adjuvant temozolomide chemotherapy
  • Alkylating agents
  • Glioma
  • Therapy-related myelodysplastic syndrome/acute myeloid leukemia

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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