Complications of a temozolomide overdose: a case report.

Journal of Neuro-oncology
Alexander M SpenceRichard A Peterson

Abstract

This is a report of a 53 year-old man with a glioblastoma multiforme (GBM) treated with an excessive dose of temozolomide (TMZ). This is a single case review of all clinically relevant records. O6-methylguanine-DNA methyltransferase activity was determined by a biochemical assay. 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. 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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Citations

Mar 23, 2019·BMJ Case Reports·Jamia AhmadDipesh Kumar Barua
May 27, 2015·American Journal of Hematology·Taxiarchis V KourelisMrinal M Patnaik
Jun 26, 2008·The Canadian Journal of Neurological Sciences. Le Journal Canadien Des Sciences Neurologiques·Fleur HuangDavid Roberge
May 1, 2012·Journal of Neuro-oncology·Dagmar BeierChristoph P Beier
Jul 18, 2008·Cancer Research·Dagmar BeierChristoph P Beier
Mar 10, 2015·ACS Applied Materials & Interfaces·Chen FangMiqin Zhang

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