Myelodysplastic syndrome following therapy for brain tumor--two case reports.

Abstract

A 3-month-old boy and a 29-year-old woman presented with myelodysplastic syndrome (MDS) following therapy for primary malignant brain tumor. Both received intensive alkylating agent doses for induction and maintenance chemotherapy combined with craniospinal or cranial radiation for medulloblastoma and anaplastic astrocytoma, respectively. They developed refractory anemia and pancytopenia. Approximately 9 years after the completion of induction chemoradiotherapy, chromosomal analysis of bone marrow cells resulted in the diagnosis of MDS. The boy died of leukemic evolution 15 months later, the woman died of hematopoietic failure 3 months later. The most common symptom of MDS is refractory anemia, either alone or as part of bi- or pancytopenia. Clonal proliferation with chromosomal analysis of bone marrow cells establishes the diagnosis of MDS. Patients with malignant brain tumors are at risk of the development of MDS as a late complication of chemotherapy based on high cumulative doses of alkylating agents.

• Authors: Kazuhiko Sugiyama, Kaoru Kurisu, Kazunori Arita, Eiji Taniguchi, Tatsunori Okamura, Yoko Itoh, Fumiyuki Yamasaki, Yoshinori Kajiwara, Haruo Ueda, Akira Sakai
• Journal: Neurologia medico-chirurgica (Neurol Med Chir (Tokyo)) Vol. 42 Issue 4 Pg. 170-4 (Apr 2002) ISSN: 0470-8105 [Print] Japan
• PMID: 12013670 (Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Antineoplastic Agents, Alkylating

Topics

• Adult
• Antineoplastic Agents, Alkylating (adverse effects)
• Astrocytoma (drug therapy, radiotherapy)
• Brain Neoplasms (drug therapy, radiotherapy)
• Combined Modality Therapy
• Fatal Outcome
• Female
• Humans
• Infant
• Male
• Medulloblastoma (drug therapy, radiotherapy)
• Myelodysplastic Syndromes (chemically induced)