Observational studyNeuro-oncology2022
Characterization and prognosis of temozolomide-induced aplastic anemia in patients with central nervous system malignancies.
Observational study in Neuro-oncology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 2 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
10 citing papers in PubMed, 2 syntheses or guidelines pooled it, 16 citations in OpenAlex.
- The Effect of Interferon Type I Adjuvant Therapy on the Lifespan and Complications of Glioma Patients Undergoing Chemotherapy: A Systematic Review and Meta-Analysis.Cancer reports (Hoboken, N.J.) · 2026Pooled it
- Pooled it
- Pharmacovigilance assessment of drug-induced aplastic anemia: analysis of the FDA adverse event reporting system.International journal of clinical pharmacy · 2025Article
- Overcoming temozolomide resistance in glioma: recent advances and mechanistic insights.Acta neuropathologica communications · 2025Review
- Iron content of glioblastoma tumours and role of ferrous iron in the hypoxic responseFrontiers in oncology · 2025Article
- Multidisciplinary approaches to study anaemia with special mention on aplastic anaemia (Review).International journal of molecular medicine · 2024Review
- Optimal management of chemotherapy-induced thrombocytopenia with thrombopoietin receptor agonists.Blood reviews · 2024Review
- Treatment of chemotherapy-induced thrombocytopenia with monotherapy versus combination therapy: the devil is in the details.Research and practice in thrombosis and haemostasis · 2023Article
- Lymphoproliferative disorder during temozolomide therapy; a representative case of a formidable complication and management challenges.BMC neurology · 2023Article
- Research progress on the role of the Wnt signaling pathway in pituitary adenoma.Frontiers in endocrinology · 2023Review
Corrections and comments
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTemozolomide-induced aplastic anemia (TIAA) is a rare but highly challenging complication of temozolomide (TMZ) therapy. Evidence describing prognosis, clinical characteristics, and treatment of this entity is very limited.
methodsWe performed a multicenter, 22-year observational cohort study of patients with central nervous system (CNS) malignancies treated with temozolomide who developed TIAA, retrospectively analyzing prognosis, complications, and recovery. TIAA was defined using adapted evidence-based severe aplastic anemia criteria incorporating profound cytopenias and a minimum duration (4 weeks) without hematologic recovery.
resultsOf 3821 patients with CNS malignancies receiving TMZ, 34 patients (0.89%) met criteria for TIAA. Onset was rapid, with 29 patients (85.3%) developing TIAA before completing a second TMZ cycle. 23 patients (67.6%) ultimately achieved a hematologic recovery. Patients without recovery were more likely to develop febrile neutropenia (72.7% vs. 30.4%, P = .03), infectious complications (45.5% vs. 8.7%, P = .02), require hospitalization (81.8% vs. 43.5%, P = .04), and die (100.0% vs. 60.9%, P = .02). Median overall survival from TIAA diagnosis was 752 days in patients achieving a partial hematologic recovery versus 28 days in those who did not (P < .0001). 29 patients (85.3%) received one or more hematopoietic growth factors; hematologic recovery rates were higher in patients receiving thrombopoietin receptor agonists (81.8% vs. 60.9%) but were not higher in patients receiving granulocyte colony-stimulating factors.
conclusionsTIAA occurs in <1% of patients receiving TMZ for CNS malignancies, but is highly morbid when it occurs and frequently fatal in the one-third of patients not achieving hematologic recovery. Thrombopoietin receptor agonists may improve the likelihood of a hematologic recovery.
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