Temozolomide-induced aplastic anaemia and incidental low-grade B-cell non-Hodgkin lymphoma in a geriatric patient with glioblastoma multiforme.
Felipe BataliniMatthew R KaufmannGabriel Francisco AleixoReed DrewsPublished in: BMJ case reports (2019)
Glioblastoma multiforme is an astrocyte-derived tumour representing the most aggressive primary brain malignancy. The median overall survival is 10-12 months, but it drops to 3-8.5 months for the cohort with more than 65 years old, which account to half of all patients. Initial management in this patient population aims to balance overall patient survival and quality of life with the inherent risks of treatment intervention, which include maximal safe tumour resection, radiation and temozolomide (TMZ) chemotherapy. This is accomplished through risk stratification as a function of patient age, functional status, comorbidities, tumour location and methylguanine methyltransferase promoter methylation status. We describe the care of a patient with prolonged febrile neutropaenia, with a rare but fatal complication from TMZ-induced idiosyncratic reaction, leading to aplastic anaemia and a provoking diagnosis of low-grade B-cell non-Hodgkin's lymphoma.
Keyphrases
- resistance training
- low grade
- case report
- high grade
- newly diagnosed
- randomized controlled trial
- end stage renal disease
- healthcare
- dna methylation
- chronic kidney disease
- squamous cell carcinoma
- high glucose
- drug induced
- ejection fraction
- blood pressure
- palliative care
- diabetic rats
- multiple sclerosis
- risk assessment
- oxidative stress
- rectal cancer
- quality improvement
- radiation therapy
- chronic pain
- acute myeloid leukemia
- free survival
- brain injury
- locally advanced
- heart rate
- functional connectivity
- cerebral ischemia
- pain management
- iron deficiency