Acute myeloblastic leukemia following prolonged treatment of Crohn's disease with 6-mercaptopurine.
A 65-year-old man with Crohn's disease died of acute myeloblastic leukemia after treatment for 11.8 years with 6-mercaptopurine, 1.5 mg/kg/day (100 mg/day). On cytogenetic analysis, most of the malignant bone marrow cells had deletion of chromosome 7, the most frequently reported cytogenetic abnormality in chemotherapy-related acute leukemia. This finding, together with previous reports of acute leukemia and other malignancies following prolonged treatment with azathioprine or 6-mercaptopurine for nonmalignant conditions including inflammatory bowel disease, indicates that long-term use of these drugs for inflammatory bowel disease may increase the risk of malignancy. However, the magnitude of the risk is unknown.
Heizer
W D
WD
Department of Medicine, The University of North Carolina at Chapel Hill, 27599-7080, USA.
Peterson
J L
JL
D000368:Aged; D002872:Chromosome Deletion; D002897:Chromosomes, Human, Pair 7 / Q000235:genetics; D003424:Crohn Disease / Q000188:drug therapy*; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D015470:Leukemia, Myeloid, Acute / Q000139:chemically induced* / Q000235:genetics; D008297:Male; D015122:Mercaptopurine / Q000009:adverse effects* / Q000627:therapeutic use
D007166:Immunosuppressive Agents; D015122:Mercaptopurine