title: A case of therapy-related myeloid neoplasm in a patient with Crohn's disease treated with azathioprine.
abstract: Acute leukaemia (AL) has been observed in association with Crohn's disease (CD) notably in patients treated with azathioprine (AZA), which is an immunosuppressant known for its carcinogenicity and in particular known to induce therapy-related acute myeloid leukaemia according to the 2008 WHO classification. Whereas the link between inflammatory bowel disease and AL has been well established, the exact role of AZA remains controversial. In this paper, we report the case of a 71-year-old white Caucasian male with CD treated for 7 years with AZA who developed an acute leukaemia. Chemotherapy was administered unsuccessfully and the patient died from this haematological disorder 9 months after diagnosis. We reviewed the current evidence on the interactions between CD, AL and AZA as well as the potential underlying mechanisms of leukaemia in AZA-treated patients. From this review, we concluded that AL should be questioned when facing cytopenia in a patient with CD. The nature of the association between AZA and AL in CD patients warrants further investigation.
authors.affiliation: Hematology Laboratory-NTHC-NARILIS, CHU Mont-Godinne, 1 Avenue Gaston Therasse, Yvoir, Belgium. mullierfrancois@gmail.com
authors.forename: François
authors.initials: F
authors.lastname: Mullier
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Rahier
authors.forename: François
authors.initials: F
authors.lastname: Maignen
authors.forename: Yvan
authors.initials: Y
authors.lastname: Cornet
authors.forename: Carlos
authors.initials: C
authors.lastname: Graux
authors.forename: Christian
authors.initials: C
authors.lastname: Chatelain
authors.forename: Bernard
authors.initials: B
authors.lastname: Chatelain
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Dogne
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001379:Azathioprine / Q000009:adverse effects / Q000627:therapeutic use*; D001853:Bone Marrow / Q000473:pathology; D002869:Chromosome Aberrations; D003424:Crohn Disease / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D016130:Immunophenotyping; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D007621:Karyotyping; D015470:Leukemia, Myeloid, Acute / Q000139:chemically induced / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D008297:Male; D014805:Vitamin B 12 / Q000627:therapeutic use
chemical_list: D000970:Antineoplastic Agents; D007166:Immunosuppressive Agents; D001379:Azathioprine; D014805:Vitamin B 12