Adalimumab therapy following granulocyte and monocyte adsorptive apheresis in a patient with Crohn's disease accompanied by chronic myeloid leukemia

被引：2
作者：
Tsutomu Mizoshita
Satoshi Tanida
Shigeru Kusumoto
Keiji Ozeki
Hironobu Tsukamoto
Masahide Ebi
Yoshinori Mori
Hiromi Kataoka
Takeshi Kamiya
Takashi Joh
机构：
[1] Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Mizuho-ku, Nagoya 467-8601, 1-Kawasumi, Mizuho-cho
[2] Department of Medical Oncology and Immunology, Nagoya City University Graduate School of Medical Sciences, Mizuho-ku, Nagoya 467-8601, 1-Kawasumi, Mizuho-cho
来源：
Clinical Journal of Gastroenterology | 2012年 / 5卷 / 4期
关键词：
Adalimumab; Chronic myeloid leukemia; Crohn's disease; Intensive granulocyte and monocyte adsorptive apheresis;
D O I：
10.1007/s12328-012-0314-5
中图分类号：
学科分类号：
摘要：
A 52-year-old woman was diagnosed with Crohn's disease (CD) of the large intestine in May 2001. Her disease was accompanied by the development of chronic myelogenous leukemia (CML) in December 2003. Remission of her CML has been maintained up to the present with tyrosine kinase inhibitors. Clinical and endoscopic remission of the patient's CD was maintained with salazosulfapyridine (3000 mg/day) and occasional prednisolone (B20 mg/day) from 2001 to 2010. However, in December 2010 the patient complained of abdominal pain and diarrhea more than 10 times a day. Endoscopy showed serpiginous (snake-like) ulcers in the transverse colon and aphthous ulcers in the sigmoid colon. Intensive granulocyte and monocyte adsorptive apheresis (GMA) (two sessions per week, total of ten sessions) was performed, and the CD activity index (CDAI) decreased from 259 to 175. Six adalimumab injections were administered to improve the remaining inflammatory mucosa. Two months after induction therapy with adalimumab, the CDAI decreased from 175 to 107 without side effects. Endoscopy revealed mucosal healing of the colonic inflammatory lesions. We experienced a case of a patient with CD accompanied by CML. We successfully treated the patient by a combination of intensive GMA and adalimumab. © 2012 Springer.
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页码：302 / 306
页数：4
相关论文
共 26 条
[1]  
Van Deventer S.J., Tumour necrosis factor and Crohn's disease, Gut, 40, pp. 443-448, (1997)
[2]  
Hanauer S.B., Sandborn W.J., Rutgeerts P., Et al., Human anti-tumor necrosis factor monoclonal antibody (adalimumab) in Crohn's disease: The CLASSIC-I trial, Gastroenterology, 130, pp. 323-333, (2006)
[3]  
Ljung T., Thomsen O.O., Vatn M., Et al., Granulocyte, monocyte/ macrophage apheresis for inflammatory bowel disease: The first 100 patients treated in Scandinavia, Scand J Gastroenterol, 42, pp. 221-227, (2007)
[4]  
Suzuki Y., Yoshimura N., Saniabadi A.R., Et al., Selective granulocyte and monocyte adsorptive apheresis as a first-line treatment for steroid naive patients with active ulcerative colitis: A prospective uncontrolled study, Dig Dis Sci, 49, pp. 565-571, (2004)
[5]  
Sakuraba A., Motoya S., Watanabe K., Et al., An open-label prospective randomized multicenter study shows very rapid remission of ulcerative colitis by intensive granulocyte and monocyte adsorptive apheresis as compared with routine weekly treatment, Am J Gastroenterol, 104, pp. 2990-2995, (2009)
[6]  
Druker B.J., Guilhot F., O'Brien S.G., Et al., Five-year follow-up of patients receiving imatinib for chronic myeloid leukemia, N Engl J Med, 355, pp. 2408-2417, (2006)
[7]  
Talpaz M., Shah N.P., Kantarjian H., Et al., Dasatinib in imatinibresistant Philadelphia chromosome-positive leukemias, N Engl J Med, 354, pp. 2531-2541, (2006)
[8]  
Weisberg E., Manley P., Mestan J., Et al., AMN107 (nilotinib): A novel and selective inhibitor of BCR-ABL, Br J Cancer, 94, pp. 1765-1769, (2006)
[9]  
Makarem J.A., Otrock Z.K., Sharara A.I., Et al., Crohn's disease in leukemia: Report of a case, with a review of the literature, Dig Dis Sci, 50, (2005)
[10]  
Hatake K., Tanaka M., Muroi K., Et al., Leukaemia risk in Crohn's disease, Lancet, 347, pp. 1049-1050, (1996)
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