A Case of Therapy-Related Myeloid Neoplasm in a Patient with Crohn's Disease Treated with Azathioprine

被引：6

作者：

Mullier, Francois ^{[1
,4
]}

Rahier, Jean-Francois ^{[2
]}

Maignen, Francois ^{[5
]}

Cornet, Yvan ^{[1
]}

Graux, Carlos ^{[3
]}

Chatelain, Christian ^{[3
]}

Chatelain, Bernard ^{[1
]}

Dogne, Jean-Michel ^{[4
]}

机构：

[1] CHU Mt Godinne, Hematol Lab NTHC NARILIS, BE-5530 Yvoir, Belgium

[2] CHU Mt Godinne, Dept Hepatogastroenterol, BE-5530 Yvoir, Belgium

[3] CHU Mt Godinne, Dept Hematol, BE-5530 Yvoir, Belgium

[4] Univ Namur, FUNDP, Dept Pharm NTHC NARILIS, Namur, Belgium

[5] European Med Agcy, Pharmacovigilance & Risk Management Sect, London, England

来源：

ACTA HAEMATOLOGICA | 2012年 / 128卷 / 01期

关键词：

Acute leukaemia; Autoimmune disease; Azathioprine; Crohn's disease; Inflammatory bowel disease; Thiopurine S-methyltransferase; Vitamin B-12; INFLAMMATORY-BOWEL-DISEASE; ACUTE MYELOCYTIC-LEUKEMIA; MYELODYSPLASTIC SYNDROME; GENETIC-POLYMORPHISM; ASSOCIATION; TPMT; ABNORMALITY; THIOPURINES; DEFICIENCY; MECHANISMS;

D O I：

10.1159/000337046

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Acute leukaemia (AL) has been observed in association with Crohn's disease (CD) notably in patients treated with azathioprine (AZA), which is an immunosuppressant known for its carcinogenicity and in particular known to induce therapy-related acute myeloid leukaemia according to the 2008 WHO classification. Whereas the link between inflammatory bowel disease and AL has been well established, the exact role of AZA remains controversial. In this paper, we report the case of a 71-year-old white Caucasian male with CD treated for 7 years with AZA who developed an acute leukaemia. Chemotherapy was administered unsuccessfully and the patient died from this haematological disorder 9 months after diagnosis. We reviewed the current evidence on the interactions between CD, AL and AZA as well as the potential underlying mechanisms of leukaemia in AZA-treated patients. From this review, we concluded that AL should be questioned when facing cytopenia in a patient with CD. The nature of the association between AZA and AL in CD patients warrants further investigation. Copyright (C) 2012 S. Karger AG, Basel

引用

页码：1 / 6

页数：6

共 44 条

[1]

ANSTEY A, 1992, J ROY SOC MED, V85, P752

[2] Azathioprine-associated acute myeloid leukaemia with trilineage dysplasia and complex karyotype: a case report and review of the literature [J].

Arnold, JA ;

Ranson, SA ;

Abdalla, SH .

CLINICAL AND LABORATORY HAEMATOLOGY, 1999, 21 (04) :289-292

[3] Lymphoproliferative disorders in patients receiving thiopurines for inflammatory bowel disease: a prospective observational cohort study [J].

Beaugerie, Laurent ;

Brousse, Nicole ;

Bouvier, Anne Marie ;

Colombel, Jean Frederic ;

Lemann, Marc ;

Cosnes, Jacques ;

Hebuterne, Xavier ;

Cortot, Antoine ;

Bouhnik, Yoram ;

Gendre, Jean Pierre ;

Simon, Tabassome ;

Maynadie, Marc ;

Hermine, Olivier ;

Faivre, Jean ;

Carrat, Fabrice .

LANCET, 2009, 374 (9701) :1617-1625

[4] Rapid progression of myelodysplastic syndrome to acute myeloid leukemia on sequential azathioprine, IFN-β and copolymer-1 in a patient with multiple sclerosis [J].

Bergh, Florian Then ;

Niklas, Alexander ;

Strauss, Angelika ;

von Ahsen, Nicolas ;

Niederwieser, Dietger ;

Schwarz, Johannes ;

Wagner, Armin ;

Al-Ali, Haifa K. .

ACTA HAEMATOLOGICA, 2006, 116 (03) :207-210

[5] THE ASSOCIATION OF INFLAMMATORY BOWEL-DISEASE AND LEUKEMIA - COINCIDENCE OR NOT [J].

CASPI, O ;

POLLIACK, A ;

KLAR, R ;

BENYEHUDA, D .

LEUKEMIA & LYMPHOMA, 1995, 17 (3-4) :255-262

[6] Avoiding adverse drug reactions by pharmacogenetic testing: A systematic review of the economic evidence in the case of TPMT and AZA-induced side effects [J].

Compagni, Amelia ;

Bartoli, Simona ;

Buehrlen, Bernhard ;

Fattore, Giovanni ;

Ibarreta, Dolores ;

de Mesa, Emma Gutierrez .

INTERNATIONAL JOURNAL OF TECHNOLOGY ASSESSMENT IN HEALTH CARE, 2008, 24 (03) :294-302

[7] Impact of the increasing use of immunosuppressants in Crohn's disease on the need for intestinal surgery [J].

Cosnes, J ;

Nion-Larmurier, I ;

Beaugerie, L ;

Afchain, P ;

Tiret, E ;

Gendre, JP .

GUT, 2005, 54 (02) :237-241

[8] Limitations of extensive TPMT genotyping in the management of azathioprine-induced myelosuppression in IBD patients [J].

Dewit, O. ;

Moreels, T. ;

Baert, F. ;

Peeters, H. ;

Reenaers, C. ;

de Vos, M. ;

Van Hootegem, Ph. ;

Muls, V. ;

Veereman, G. ;

Mana, F. ;

Van Outryve, M. ;

Holvoet, J. ;

Naegels, S. ;

Piessevaux, H. ;

Horsmans, Y. ;

Gala, J. L. .

CLINICAL BIOCHEMISTRY, 2011, 44 (13) :1062-1066

[9] The second European evidence-based Consensus on the diagnosis and management of Crohn's disease: Current management [J].

Dignass, A. ;

Van Assche, G. ;

Lindsay, J. O. ;

Lemann, M. ;

Soderholm, J. ;

Colombel, J. F. ;

Danese, S. ;

D'Hoore, A. ;

Gassull, M. ;

Gomollon, F. ;

Hommes, D. W. ;

Michetti, P. ;

O'Morain, C. ;

Oresland, T. ;

Windsor, A. ;

Stange, E. F. ;

Travis, S. P. L. .

JOURNAL OF CROHNS & COLITIS, 2010, 4 (01) :28-62

[10]

DOMBRET H, 1995, NOUV REV FR HEMATOL, V37, P193

← 1 2 3 4 5 →