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Secondary malignancies due to alkylating agents or topoisomerase II inhibitors are a concern in patients treated for primary brain tumors of the nervous system. Myelosuppression is the dose-limiting toxic effect of the alkylating agent temozolomide; reversible hematologic toxicity consisting mainly of thrombocytopenia is reported to occur in 7% of patients treated with concomitant radiotherapy and temozolomide and 14% with adjuvant temozolomide.1 However, the incidence of secondary malignancies and nonreversible hematologic disorders, such as myelodysplastic syndrome, are a rare complication of temozolomide.2
Footnotes
Author contributions: Dr. Clark, Dr. Taylor, and Daphne Wang compiled the data. Dr. Clark, Dr. Abramson, and Dr. Batchelor wrote the article.
Study funding: No targeted funding reported.
Disclosure: The authors report no disclosures relevant to the manuscript. Go to Neurology.org for full disclosures.
- Received October 19, 2012.
- Accepted in final form February 28, 2013.
- © 2013 American Academy of Neurology
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