Aplastic anemia associated with Crohn’s disease: a tertiary center retrospective study

Su, Song; Liu, Zhen Zhen; Wang, Fang; Zhang, Yujie; Chu, Yi; Jiang, Mingzuo; Xu, Bing; Wu, Nan; Lin, Jia; Xue, Xianmin; Shi, Yongquan; Yang, Shaoqi; Wu, Kaichun; Liang, Jie

doi:10.1007/s00277-019-03729-4

Cited by 4 publications

(2 citation statements)

References 13 publications

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“…Aplastic anaemia relation to IBD may be considered a matter of association rather than complication or extra intestinal manifestation making the treatment of such cases a big challenge. The association of AA is more common with UC than CD, yet six cases of CD were reported associated with AA [9]. It was reported that in more than half of the cases there is a favourable response to treatment with immunosuppressants for patients with UC and AA due to the common immune pathogenesis [10].…”

Section: Discussionmentioning

confidence: 99%

Ulcerative colitis associated with aplastic anemia and extra intestinal manifestations: Case presentation

Maher¹,

Adel²,

Rizk³

2020

Gastroenterol Hepatol Endosc

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Association between inflammatory bowel disease (IBD) and myelodysplastic syndrome, in particular aplastic anaemia was reported with possible share a common immune dysfunction pathway. Extra intestinal manifestations of IBD are also common and usually related to the activity of IBD. We report a case of active ulcerative colitis associated with aplastic anaemia, dermatological and thromboembolic extra intestinal manifestations.

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Section: Discussionmentioning

confidence: 99%

Ulcerative colitis associated with aplastic anemia and extra intestinal manifestations: Case presentation

Maher¹,

Adel²,

Rizk³

2020

Gastroenterol Hepatol Endosc

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“…An association between AHF and gut inflammatory conditions has long been proposed ( 89 , 90 , 341 ). Patients with AA have a dysbiotic gut microbiota ( 342 ), and the immunological signature of AA is the same as that of IBD ( 343 ), which suggests that AA and IBD may share similar initiating factors and common pathogenic agents ( 1 , 2 , 344 , 345 ).…”

Section: Particular Attention Should Be Given To Gut Inflammatory Dis...mentioning

confidence: 99%

When inflammatory stressors dramatically change, disease phenotypes may transform between autoimmune hematopoietic failure and myeloid neoplasms

Zhao,

Ju,

Xiu

et al. 2024

Front. Immunol.

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Aplastic anemia (AA) and hypoplastic myelodysplastic syndrome are paradigms of autoimmune hematopoietic failure (AHF). Myelodysplastic syndrome and acute myeloid leukemia are unequivocal myeloid neoplasms (MNs). Currently, AA is also known to be a clonal hematological disease. Genetic aberrations typically observed in MNs are detected in approximately one-third of AA patients. In AA patients harboring MN-related genetic aberrations, a poor response to immunosuppressive therapy (IST) and an increased risk of transformation to MNs occurring either naturally or after IST are predicted. Approximately 10%–15% of patients with severe AA transform the disease phenotype to MNs following IST, and in some patients, leukemic transformation emerges during or shortly after IST. Phenotypic transformations between AHF and MNs can occur reciprocally. A fraction of advanced MN patients experience an aplastic crisis during which leukemic blasts are repressed. The switch that shapes the disease phenotype is a change in the strength of extramedullary inflammation. Both AHF and MNs have an immune-active bone marrow (BM) environment (BME). In AHF patients, an inflamed BME can be evoked by infiltrated immune cells targeting neoplastic molecules, which contributes to the BM-specific autoimmune impairment. Autoimmune responses in AHF may represent an antileukemic mechanism, and inflammatory stressors strengthen antileukemic immunity, at least in a significant proportion of patients who have MN-related genetic aberrations. During active inflammatory episodes, normal and leukemic hematopoieses are suppressed, which leads to the occurrence of aplastic cytopenia and leukemic cell regression. The successful treatment of underlying infections mitigates inflammatory stress-related antileukemic activities and promotes the penetration of leukemic hematopoiesis. The effect of IST is similar to that of treating underlying infections. Investigating inflammatory stress-powered antileukemic immunity is highly important in theoretical studies and clinical practice, especially given the wide application of immune-activating agents and immune checkpoint inhibitors in the treatment of hematological neoplasms.

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2019

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Aplastic anemia associated with Crohn’s disease: a tertiary center retrospective study

Cited by 4 publications

References 13 publications

Ulcerative colitis associated with aplastic anemia and extra intestinal manifestations: Case presentation

Ulcerative colitis associated with aplastic anemia and extra intestinal manifestations: Case presentation

When inflammatory stressors dramatically change, disease phenotypes may transform between autoimmune hematopoietic failure and myeloid neoplasms

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