title: Treatment of Crohn's disease complicated with myelodysplastic syndrome via allogeneic hematopoietic stem cell transplantation: case report and literature review.
abstract: Crohn's disease (CD) is a chronic inflammatory disease of the gastrointestinal tract arising in individuals with genetic predisposing factors and abnormalities of the immune system. Myelodysplastic syndrome (MDS), an acquired clonal hematologic disorder, is characterized by peripheral blood cytopenia, dysplastic changes in several types of hematopoietic cells of the bone marrow and peripheral blood, and a high risk of transformation to acute leukemia. CD rarely occurs in combination with MDS, and MDS treatment with hematopoietic stem cell transplantation (HSCT) has not been frequently reported. We report the case of a 50-year-old Chinese male who presented with abdominal pain, diarrhea, and fatigue. CD was diagnosed by colonoscopy, imaging studies, and pathological examination. He was initially treated with mesalazine and prednisone and thereafter he presented with pancytopenia. MDS (RAEB-I) was diagnosed by bone marrow examination, and karyotyping revealed 47, XY, +8. The patient was treated with thalidomide, andriol, and decitabine. Allogeneic HSCT was performed with a human leukocyte antigen-matched sibling as the donor. The patient is currently well at 14 months after HSCT, without abdominal pain, diarrhea, or fatigue. HSCT may be a promising treatment option for patients with combined CD and MDS.
authors.affiliation: Department of Gastroenterology, Second Xiang Ya Hospital, Central South University, 139 Mid RenMin Road, Changsha, 410011 Hunan People's Republic of China.
authors.forename: Changmei
authors.initials: C
authors.lastname: Hu
authors.affiliation: Department of Gastroenterology, Second Xiang Ya Hospital, Central South University, 139 Mid RenMin Road, Changsha, 410011 Hunan People's Republic of China.
authors.forename: Liang
authors.initials: L
authors.lastname: Lv
authors.affiliation: Department of Gastroenterology, Second Xiang Ya Hospital, Central South University, 139 Mid RenMin Road, Changsha, 410011 Hunan People's Republic of China.
authors.forename: Deliang
authors.initials: D
authors.lastname: Liu
authors.affiliation: Department of Gastroenterology, Second Xiang Ya Hospital, Central South University, 139 Mid RenMin Road, Changsha, 410011 Hunan People's Republic of China.
authors.forename: Jirong
authors.initials: J
authors.lastname: Huo
mesh_terms: D003424:Crohn Disease / Q000150:complications* / Q000601:surgery*; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000150:complications*; D014184:Transplantation, Homologous
keywords: Allogeneic hematopoietic cell transplantation; Crohn’s disease; Hematopoietic stem cell transplantation; Inflammatory bowel disease; Myelodysplastic syndrome