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.
Department of Medicine, The University of North Carolina at Chapel Hill, 27599-7080, USA.
W D
WD
Heizer
J L
JL
Peterson
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