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This multicenter, retrospective study in Alberta, Canada showed a significant increase in Grade 3 or 4 neutropenia and thrombocytopenia events with generic TMZ as compared to the brand name TMZ. The results of this study prompted Alberta neuro-oncologists to stop prescribing the generic and revert back to name brand. If you are a brain tumor patient experiencing bone marrow toxicity with generic TMZ, ask your NO about switching to the name brand (Merck).