[Temozolomide, an oral chemotherapeutic agent with potential severe toxicity]

Two patients, a 58-year-old man and a 55-year-old woman, both under treatment for glioblastoma multiforme, were admitted with fever and neutropenia a few weeks after starting to take the oncolytic agent temozolomide. The man died of a cerebral haemorrhage against a background of severe thrombocytopenia and febrile neutropenia, and the woman died of neutropenic sepsis. Temozolomide is an oral alkylating agent that is considered to be a well-tolerated chemotherapeutic agent. It is important to be aware of the potentially life-threatening toxicity of every chemotherapeutic agent, including temozolomide. Therefore, temozolomide should be prescribed only by doctors with sufficient clinical experience with treatment by means of oncolytic agents, and with the recognition of the side effects and treatment of the complications of chemotherapy. In view of the multidisciplinary aspects of the treatment of patients with glioblastoma multiforme, treatment by a specialised team is preferable.