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Development of acute myelocytic leukemia in patients with Crohn's disease
L Halme1, J von Knorring, E Elonen
1Fourth Department of Surgery, Helsinki University Central Hospital, Finland.
Insights
Two Crohn's disease patients developed acute myelocytic leukemia, a rare occurrence. Further research is needed to explore the potential link between Crohn's disease and acute leukemia, particularly with monocytic differentiation.
Area of Science:
- Gastroenterology
- Hematology
- Oncology
Background:
- Crohn's disease is a chronic inflammatory bowel disease.
- Leukemia is a cancer of blood-forming tissues.
- Ulcerative colitis patients may have an increased risk of leukemia.
Observation:
- Two cases of Crohn's disease patients developing acute myelocytic leukemia within one year at a single hospital.
- A literature review identified eight previously reported cases, totaling 10 patients with both conditions.
- Six of the 10 patients had acute myelocytic leukemia, with three exhibiting monocytic differentiation (FAB type M4).
Findings:
- A notable proportion of patients with Crohn's disease and leukemia presented with acute myelocytic leukemia.
- Monocytic differentiation (FAB type M4) was observed in three of the 10 reported cases, including the two new cases.
- The co-occurrence of Crohn's disease and acute myelocytic leukemia, especially with monocytic features, warrants further investigation.
Implications:
- The findings suggest a potential, though not yet fully understood, association between Crohn's disease and acute myelocytic leukemia.
- More data is required to confirm and evaluate the risk of developing leukemia in patients with Crohn's disease.
- This highlights the importance of considering hematological malignancies in patients with inflammatory bowel diseases.
Abstract:
In our hospital within one year two patients with Crohn's disease were seen who developed an acute myelocytic leukemia. A review of the literature reveals eight previously reported patients with both Crohn's disease and leukemia. Six of the reported 10 patients have had acute myelocytic leukemia and, interestingly, three of them, including our two patients, have shown monocytic differentiation (FAB type M4). It has been suggested that the relative risk of leukemia, especially acute myelocytic leukemia, is increased in patients suffering from ulcerative colitis. More data of patients with Crohn's disease and acute leukemia are needed to evaluate the possible association between these diseases.