Abstract
Background:
Standard treatment of glioblastoma multiforme consists of postoperative radiochemotherapy with temozolomide, followed by a 6-month chemotherapy. Serious hematologic complications are rarely reported.
Case Report and Results:
The authors present the case of a 61-year-old female patient with glioblastoma multiforme treated with external-beam radiation therapy and concomitant temozolomide. After completion of treatment, the patient developed symptoms of serious aplastic anemia that eventually led to death due to prolonged neutro- and thrombocytopenia followed by infectious complications.
Conclusion:
Lethal complications following temozolomide are, per se, extremely rare, however, a total of four other cases of aplastic anemia have been reported in the literature so far.
Zusammenfassung
Hintergrund:
Die Standardbehandlung des Glioblastoma multiforme ist die postoperative Radiochemotherapie mit Temozolomid, gefolgt von einer 6-monatigen Erhaltungschemotherapie. Schwerwiegende hämatologische Toxizitäten werden selten berichtet.
Fallbericht und Ergebnisse:
Die Autoren präsentieren den Fall einer 61-jahrigen Patientin mit Glioblastoma multiforme, die mit externer Strahlentherapie und begleitender Temozolomidchemotherapie in Standarddosierung behandelt wurde. Nach Abschluss der Behandlung zeigte die Patientin Symptome einer schweren aplastischen Anämie, die infolge prolongierter Neutro- und Thrombopenie durch infektiöse Komplikationen zum Tode führte.
Schlussfolgerung:
Letale Komplikationen einer Temozolomidchemotherapie sind selten, bislang wurden insgesamt vier Fälle einer aplastischen Anämie in der Literatur berichtet.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
Doyle TJ, Mikkelsen T, Croteau D, et al. Fatal hematologic toxicity with prolonged continuous administration of temozolomide (TMZ) during radiation therapy (RT) in the treatment of newly-diagnosed glioblastoma multiforme (GBM): report of a phase II trial. ASCO Annual Meeting Proceedings. J Clin Oncol 2005;23:1546.
Fabrini MG, Perrone F, De Franco L, et al. Perioperative high-dose-rate brachytherapy in the treatment of recurrent malignant gliomas. Strahlenther Onkol 2009;185:524–9.
Fokas E, Wacker U, Gross MW, et al. Hypofractionated stereotactic reirradiation of recurrent glioblastomas. A beneficial treatment option after high-dose radiotherapy? Strahlenther Onkol 2009;185:235–40.
George BJ, Eichinger JB, Richard TJ. A rare case of aplastic anemia caused by temozolomide. South Med J 2009;102:974–6.
Gerber DE, Grossman SA, Zeltzman M, et al. The impact of thrombocytopenia from temozolomide and radiation in newly diagnosed adults with high-grade gliomas. Neuro Oncol 2007;9:47–52.
Hegi ME, Diserens AC, Gorlia T, et al. MGMT gene silencing and benefit from temozolomide in glioblastoma. N Engl J Med 2005;352:997–1003.
Heimans JJ, Taphoorn MJ. Impact of brain tumour treatment on quality of life. J Neurol 2002;249:955–60.
Iliadis G, Selviaridis P, Kalogera-Fountzila A, et al. The importance of tumor volume in the prognosis of patients with glioblastoma. Comparison of computerized volumetry and geometric models. Strahlenther Onkol 2009;185:743–50.
Kocher M, Frommolt P, Borberg SK, et al. Randomized study of postoperative radiotherapy and simultaneous temozolomide without adjuvant chemotherapy for glioblastoma. Strahlenther Onkol 2008;184:572–9.
Kocher M, Kunze S, Eich HT, et al. Efficacy and toxicity of postoperative temozolomide radiochemotherapy in malignant glioma. Strahlenther Onkol 2005;181:157–63.
Singhal N, Selva-Nayagam S, Brown MP. Prolonged and severe myelosuppression in two patients after low-dose temozolomide treatment — case study and review of literature. J Neurooncol 2007;85:229–30.
Stupp R, Mason WP, van den Bent MJ, et al. Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma. N Engl J Med 2005;352:987–96.
Taphoorn MJ, Klein M. Cognitive deficits in adult patients with brain tumours. Lancet Neurol 2004;3:159–68.
van Genugten JA, Leffers P, Baumert BG, et al. Effectiveness of temozolomide for primary glioblastoma multiforme in routine clinical practice. J Neurooncol 2010;96:249–57.
Villano JL, Collins CA, Manasanch EE, et al. Aplastic anaemia in patient with glioblastoma multiforme treated with temozolomide. Lancet Oncol 2006;7:436–8.
Villano JL, Seery TE, Bressler LR. Temozolomide in malignant gliomas: current use and future targets. Cancer Chemother Pharmacol 2009;64:647–55.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Kopecký, J., Priester, P., Slováček, L. et al. Aplastic Anemia as a Cause of Death in a Patient with Glioblastoma Multiforme Treated with Temozolomide. Strahlenther Onkol 186, 452–457 (2010). https://doi.org/10.1007/s00066-010-2132-3
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00066-010-2132-3