Prolonged and severe myelosuppression in two patients after low-dose temozolomide treatment - case study and review of literature

Temozolomide is an alkylating agent used frequently in the management of gliomas. Although temozolomide is generally safe, rarely it can cause life threatening complications. Here we report the cases of two patients who developed prolonged and severe pancytopenia after low dose continuous temozolomide concurrently with cranial radiotherapy. The pancytopenia lasted two to six months. Both the patients were young, treatment naive, and had temozolomide treatment for only approximately four weeks.