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Abstract Details

Temozolomide Use in a Human Immunodeficiency Virus (HIV) Positive Patient with Glioblastoma Multiforme (GBM)
Neuro-oncology
P01 - (-)
109
Because Temozolomide reduces CD4 counts and increases risk of infection, there are concerns regarding its use in GBM patients with HIV. Available data is limited to case reports. We present successful Temozolomide use in an HIV positive patient with GBM.
Case report from a tertiary care medical center.
A 60-year-old HIV positive woman on retroviral therapy presented with left hemiparesis. Magnetic resonance imaging showed an enhancing mass lesion which was biopsied as GBM. She was able to stand with assistance but required a wheelchair. Temozolomide and radiation therapy were initiated and she continued her retroviral regimen. The treatment course was complicated by oral candidiasis, which developed after starting steroids, and was successfully treated with Fluconazole. There were no other complications and after 3 weeks, the patient was able to take a few steps with assistance. After completing standard radiation she tapered off steroids and initiated adjuvant Temozolomide. After 3 months of treatment the patient was able to ambulate with a walker. The patient's CD4 count was 202 cells/mm3 at the start of treatment and 352 cells/mm3 after 3 months.
This case illustrates the successful use of Temozolomide in an HIV positive patient. The patient tolerated the treatment well and there was no deleterious effect on her CD4 count. She did develop oral candidiasis, however it is unclear whether this was due to steroid or Temozolomide treatment. Our findings suggest that HIV positive patients may be safely treated with Temozolomide. Close attention to CD4 counts is warranted but larger case series would be helpful.
Authors/Disclosures
Cinthi Pillai, MD (NYU Langone)
PRESENTER 		Dr. Pillai has nothing to disclose.
Shouri Lahiri, MD (Cedars-Sinai Medical Center) Dr. Lahiri has received personal compensation in the range of $500-$4,999 for serving as a Consultant for AstraZeneca. Dr. Lahiri has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for medicolegal consultations.. Dr. Lahiri has stock in Prometheus. The institution of Dr. Lahiri has received research support from National Institutes of Health. The institution of Dr. Lahiri has received research support from F. Widjaja Foundation.
Jerome J. Graber, MD, MPH, FAAN (University of Washington) Dr. Graber has received personal compensation for serving as an employee of Binaytara Foundation. Dr. Graber has received personal compensation in the range of $500-$4,999 for serving as a Consultant for 好色先生. Dr. Graber has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Dickie McCamey Attorneys at Law. Dr. Graber has a non-compensated relationship as a Editorial Board member with Neuro-Oncology: Practice, published by Oxford that is relevant to AAN interests or activities. Dr. Graber has a non-compensated relationship as a Editorial Board Member with Journal of Pain and Symptom Management that is relevant to AAN interests or activities. Dr. Graber has a non-compensated relationship as a Board of Directors with American Society of Neuroimaging that is relevant to AAN interests or activities. Dr. Graber has a non-compensated relationship as a Board of Directors and Certification Exam Committee Member with United Council of Neurological Subspecialties that is relevant to AAN interests or activities. Dr. Graber has a non-compensated relationship as a Question of the Day 'app' committee and NeuroSAE and Continuum with 好色先生 that is relevant to AAN interests or activities. Dr. Graber has a non-compensated relationship as a Editorial Board Member with Practical Neurology (BMC) that is relevant to AAN interests or activities.
No disclosure on file