We report on a pediatric and an adult patient suffering from Crohn's disease (CD), treated with mercaptopurine (6-MP) and anti-TNF-α therapy, who respectively subsequently developed MDS with monosomy-7 and acute myeloid leukemia (AML). Although a link between exposure to 6-MP and anti-TNF-α and malignant lymphomas has been documented [1], the risk of developing leukemia or myelodysplasia (MDS) has not been clearly ascertained. Recent studies have shown that a higher risk of malignancies is found when patients on 6-MP, have an associated deficit of its catabolic enzyme thiopurine methyltransferase (TMPT) [2]. Heterozygousity or absence of TPMT gene is associated with myelosuppression, while anti-TNF-α therapy may favor malignancies possibly increasing the risk of developing MDS/leukemia
"Immunosuppressive treatments in Crohn's disease induce myelodysplasia and leukaemia."
ROVIGATTI, UGO;
2010-01-01
Abstract
We report on a pediatric and an adult patient suffering from Crohn's disease (CD), treated with mercaptopurine (6-MP) and anti-TNF-α therapy, who respectively subsequently developed MDS with monosomy-7 and acute myeloid leukemia (AML). Although a link between exposure to 6-MP and anti-TNF-α and malignant lymphomas has been documented [1], the risk of developing leukemia or myelodysplasia (MDS) has not been clearly ascertained. Recent studies have shown that a higher risk of malignancies is found when patients on 6-MP, have an associated deficit of its catabolic enzyme thiopurine methyltransferase (TMPT) [2]. Heterozygousity or absence of TPMT gene is associated with myelosuppression, while anti-TNF-α therapy may favor malignancies possibly increasing the risk of developing MDS/leukemiaI documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
