Acute Myeloid Leukemia with Myelodysplasia-Related Changes in a Patient with Crohn’s Disease Treated with Immunosuppressive Therapy

Abstract

We report a case of acute myeloid leukemia with myelodysplasia-related changes in a patient with Crohn’s disease. The patient was diagnosed with Crohn’s disease at the age of 47 years and was treated with the tumor necrosis factor α inhibitors adalimumab and infliximab, and a short course of azathioprine. Four years later, the patient developed acute myeloid leukemia with myelodysplasia that involved mainly erythropoiesis. Crohn’s disease is associated with an increased risk of cancers including hematological malignancies. Cancer surveillance including hematology assessment is warranted to monitor the patients on immunosuppressive therapy.

Ulcerative Colitis Concomitant with Cytomegalovirus Infection, Bullous Sweet’s Syndrome, and Acute Myeloid Leukemia: A Case Report and Literature Review

“…48 Studies have reported AML in patients with Crohn's disease or other immune diseases, who received anti-TNF-α agents (For example, adalimumab and IFX). [49][50][51] Despite the close temporal association between IFX exposure and AML in our patient, we could not conclusively establish a causal association. Because our patient received only two short cycles of IFX therapy (total dose 600.0 mg).…”