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Complications of a temozolomide overdose: a case report

  • Clinical–Patient Studies
  • Published:
Journal of Neuro-Oncology Aims and scope Submit manuscript

Abstract

Purpose and background

This is a report of a 53 year-old man with a glioblastoma multiforme (GBM) treated with an excessive dose of temozolomide (TMZ).

Methods

This is a single case review of all clinically relevant records. O 6-methylguanine-DNA methyltransferase activity was determined by a biochemical assay.

Results

Following conventional radiotherapy (RT) without concurrent chemotherapy, the patient received 5,500 mg of TMZ over 2 days. At the standard dose of 200 mg/m2/day his total 5-day dose should have been 1,940 mg. Acutely he had nausea, vomiting and diarrhea for 2 days which cleared. The dominant severe toxicity was pancytopenia between one and four weeks after TMZ which was complicated by secondary infections that were successfully managed. Transient transaminitis occurred but there were no significant pulmonary, renal or other systemic toxicities. His progression free survival was 22 months and overall survival 24 months.

Conclusion

His outcome suggests that TMZ may prove to be a good agent for dose-escalation trials with hematopoietic stem cell rescue.

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Authors and Affiliations

  1. Department of Neurology, University of Washington School of Medicine, Room RR650, 1959 NE Pacific Street, Seattle, WA, 98195, USA

    Alexander M. Spence, Sonia Partap & Richard A. Peterson

  2. Department of Medicine (Medical Oncology), University of Washington School of Medicine, 1100 Fairview Ave N, Seattle, WA, 98109, USA

    Hans-Peter Kiem & Scott Schuetze

  3. Department of Neurosurgery, University of Washington School of Medicine, 356470, 1959 NE Pacific Street, Seattle, WA, 98195, USA

    John R. Silber

Authors
  1. Alexander M. Spence
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  2. Hans-Peter Kiem
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  3. Sonia Partap
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  4. Scott Schuetze
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  5. John R. Silber
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  6. Richard A. Peterson
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Correspondence to Alexander M. Spence.

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Spence, A.M., Kiem, HP., Partap, S. et al. Complications of a temozolomide overdose: a case report. J Neurooncol 80, 57–61 (2006). https://doi.org/10.1007/s11060-006-9152-y

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  • DOI: https://doi.org/10.1007/s11060-006-9152-y

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