[Acute promyelocytic leukemia following ulcerative colitis]

Area of Science:

• Hematology
• Gastroenterology
• Oncology

Background:

• Ulcerative colitis (UC) is a chronic inflammatory bowel disease.
• Acute promyelocytic leukemia (APL) is a subtype of acute myeloid leukemia.
• The association between UC and secondary malignancies, including leukemia, is a recognized but rare phenomenon.

Observation:

• A 23-year-old male diagnosed with UC in 1991 experienced bleeding tendencies in 1993.
• Bone marrow aspiration and coagulation profiles confirmed APL with disseminated intravascular coagulation.
• The patient had been treated for UC with salazosulfapyridine and prednisolone.

Findings:

• Complete remission of APL was achieved using All-trans retinoic acid (ATRA) and chemotherapy.
• The patient unfortunately succumbed to sepsis during the consolidation chemotherapy phase.
• Autopsy confirmed no evidence of UC recurrence.

Implications:

• This case highlights a rare but serious complication of UC.
• It underscores the importance of vigilant monitoring for secondary malignancies in patients with chronic inflammatory conditions.
• The successful induction of remission with ATRA in this context warrants further investigation into APL pathogenesis in UC patients.