Treatment-related myelodysplasia/AML in a patient with a history of breast cancer and an oligodendroglioma treated with temozolomide: Case study and review of the literature1

Abstract

The emergence of temozolomide as an effective alkylating agent with little acute toxicity or cumulative myelosuppression has led to protracted courses of chemotherapy for many patients with gliomas. Secondary, or treatment-related, myelodysplasia (t-MDS) and acute myelogenous leukemia (t-AML) are life-threatening complications of alkylating chemotherapy and have been reported in patients with primary brain tumors. We describe a case of temozolomide-related t-MDS/AML and discuss the clinical features of this condition. Administration of an alkylating agent in patient populations with long median survivals must be undertaken with an understanding of the potential for this treatment complication.

Atypical breast adenosquamous carcinoma following acute myeloid leukemia in a middle-aged woman: A case report

“…Second primary breast cancer generally develops in women who are first diagnosed with endometrial, colon/rectal, stomach, ovarian, thyroid gland or skin cancers (4), although its development following AML is rare and, to our best of knowledge, no report of breast cancer following AML has been previously published. However, several cases of second primary AML following breast cancer have been noted in the literature (9)(10)(11)(12).…”

Occurrence of myelodysplastic syndrome during paclitaxel- and carboplatin-based chemotherapy for recurrent ovarian cancer: Case report

“…Therapy-related MDS/AML has been described following cytotoxic chemotherapy of malignant tumors with classic alkylating agents, including nitrosoureas or procarbazin, radiation therapy alone, or combined chemotherapy and radiotherapy [4,[9][10][11]. The risk rises with increasing age, and there no known factors other than age and duration of therapy to predict which patients might be at higher risk of the secondary diseases.…”

Neuro-Sweet disease mimicking recurrent anaplastic astrocytoma associated with therapy-related myelodysplastic syndrome: A case report

“…t-MDS/AML have been described as life-threatening complications following therapy of primary brain tumors with classic alkylating agents such as nitrosoureas or procarbazine, RT alone, or combined chemotherapy and RT [2]. Therapy-related myeloid neoplasms account for approximately 20% of all cases of myeloproliferative neoplasms.…”

“…Therapy-related myelodysplastic syndrome (t-MDS) is rare but one of the most lethal complications of alkylating agents such as temozolomide (TMZ) and ACNU [2], which are widely used for adjuvant chemotherapy with or without radiotherapy for malignant glioma. In this study, we provide the first report of NSD mimicking the recurrence of anaplastic astrocytoma (AA), which was accompanied by t-MDS, after standard chemoradiotherapy for AA.…”