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CASE REPORT
Year : 2021  |  Volume : 4  |  Issue : 1  |  Page : 15-18

Acute toxicity of temozolomide for the treatment of anaplastic astrocytoma: A case report


1 Department of Neurology, Mohammad Hoesin Hospital, Universitas Sriwijaya, Palembang, Indonesia
2 Department of Internal Medicine, Hematolo Oncology Division, Mohammad Hoesin Hospital, Universitas Sriwijaya, Palembang, Indonesia

Correspondence Address:
Dr. Yunni Diansari
Department of Neurology, Mohammad Hoesin Hospital, Universitas Sriwijaya, Jl Dr Moh Ali KM 3.5, Palembang 30662
Indonesia
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/glioma.glioma_1_21

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Temozolomide is an orally administered chemotherapeutic drug that has become a standard treatment for malignant gliomas. Severe toxicity of temozolomide is rare, especially shortly after administration. We report a 37-year-old male patient diagnosed with anaplastic astrocytoma following tumor resection. He was treated postoperatively with cranial radiation and adjuvant temozolomide 150 mg/m2 for six planned cycles. However, 3 days after finishing the first cycle of temozolomide, the patient's condition deteriorated. Laboratory results showed thrombocytopenia and lymphopenia, and chest X-ray revealed an infiltrate in the right segment of the lung, suggesting pneumonia. These conditions were thought to be caused by temozolomide. Although temozolomide is generally well tolerated by glioma patients, several adverse effects have been reported. In addition, malignancy, corticosteroids, and chemotherapy are known to increase the risk of immunosuppression. Close monitoring of patients treated with temozolomide is warranted, especially brain tumor patients, due to the risk of myelosuppression and severe infection. The work was approved by the Health Research Ethics Committee of DR Mohammad Hoesin Hospital (No. 130/kepkrsmh/2020) on December 15, 2020.


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