title: Familial adenomatous polyposis complicated by chronic myelogenous leukemia: response to imatinib mesylate.
abstract: Familial adenomatous polyposis (FAP) is an autosomal dominant disorder characterized by colonic polyposis and a predisposition for developing colorectal cancer. FAP is frequently complicated by extracolonic disease, but complications of leukemia are rare. We present the first case of FAP complicated by chronic myelogenous leukemia (CML) in a 38-year-old man. The patient had numerous adenomas in the colorectum and a family history compatible with FAP. He was diagnosed as having FAP in February 2000. Two years after the diagnosis, he developed leukocytosis with the Philadelphia chromosome abnormality, indicating complication with CML. Imatinib mesylate was administered for the treatment of CML, and hematologic and cytogenetic remission of CML was achieved in 6 months. Numerous polyps, 2 to 3 mm in diameter, observed in the rectum prior to the administration of imatinib, regressed in size, but not in number, after 1 year of treatment with imatinib. Eighteen months later, however, the polyps were enlarged. In this patient, imatinib administration led to the remission of CML and might also have been responsible for the temporary regression of adenomatous polyps of FAP.
authors.affiliation: Division of Hematology-Oncology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan.
authors.forename: Takeyoshi
authors.initials: T
authors.lastname: Itsukuma
authors.forename: Hideki
authors.initials: H
authors.lastname: Ishikawa
authors.forename: Mahito
authors.initials: M
authors.lastname: Misawa
authors.forename: Shunro
authors.initials: S
authors.lastname: Kai
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Fujimori
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Nakagawa
authors.forename: Seiichi
authors.initials: S
authors.lastname: Hirota
authors.forename: Ayako
authors.initials: A
authors.lastname: Sugihara
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Terada
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Hara
mesh_terms: D011125:Adenomatous Polyposis Coli / Q000150:complications*; D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001549:Benzamides; D006801:Humans; D000068877:Imatinib Mesylate; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000150:complications*; D008297:Male; D010879:Piperazines / Q000627:therapeutic use; D011505:Protein-Tyrosine Kinases / Q000037:antagonists & inhibitors*; D011743:Pyrimidines / Q000627:therapeutic use
chemical_list: D000970:Antineoplastic Agents; D001549:Benzamides; D010879:Piperazines; D011743:Pyrimidines; D000068877:Imatinib Mesylate; D011505:Protein-Tyrosine Kinases