Therapy-related myelodysplastic syndrome (t-MDS) in a patient with anaplastic astrocytoma: Successful treatment with allogeneic bone marrow transplant

Objective and importance: Therapy-related myelodysplastic syndrome (t-MDS) is a rare and typically fatal complication of therapy for cancer, including brain tumors. We report successful therapy of t-MDS that developed after treatment for an anaplastic astrocytoma. Clinical presentation: t-MDS developed four and one-half years after successful therapy (resection, radiation and chemotherapy) administered for a cerebral anaplastic astrocytoma in a 34-year-old patient. Intervention: The patient was treated with allogeneic bone marrow transplant (BMT) for t-MDS. Conclusion: She is alive three years after BMT with no evidence of brain tumor and in complete remission from t-MDS. To our knowledge, this is the first report of allogeneic BMT administered for t-MDS in an adult brain tumor patient. Clinicians must be alert to the development of t-MDS following chemotherapy for brain tumors and initiate appropriate treatment promptly.