Temozolomide-related acute lymphoblastic leukemia with translocation (4;11)(q21;q23) in a glioblastoma patient

Temozolomide (TMZ), an alkylating agent, is widely used for treating high-grade gliomas. TMZ has been reported to cause secondary myelodysplastic syndrome and acute myeloid leukemia. However, TMZ-related acute lymphoblastic leukemia is rare. Here we describe a 54-year-old woman with glioblastoma multiforme, who developed precursor-B acute lymphoblastic leukemia with translocation (4;11)(q21;q23) after 15 months of TMZ treatment.