Abstract
Anti-tumor necrosis factor-alpha drugs (anti-TNF-α), which are monoclonal antibodies, have revolutionized the treatment of severe and refractory inflammatory bowel disease in the last two decades. However, these drugs pose a risk for the formation of hematological malignancies such as lymphoma and acute leukemia. To our knowledge, acute lymphoblastic leukemia has been reported in the literature in only two Crohn's patients with a history of anti-TNF-α therapy. In this article, we reported a case of Philadelphia chromosome positive acute lymphoid leukemia occurring during the course of disease with a history of azathioprine and anti-TNF-α treatment with the diagnosis of Crohn's disease. In addition, we wanted to emphasize that the patient was followed up in remission for five years after allogeneic bone marrow transplantation although he did not receive treatment for Crohn's disease.
Highlights
Crohn's disease is a chronic inflammatory gastrointestinal system disease of unknown etiology that causes deterioration in the patient's quality of life [1]
We aimed to report a Philadelphia chromosome positive acute lymphoid leukemia [Ph (+) ALL] patient after the use of infliximab and azathioprine for the treatment of severe Crohn's disease
A 40-year-old patient followed by Özdemirkiran et al has a 10-year history of ankylosing spondylitis. This patient was diagnosed with Ph (+) ALL after using indomethacin and sulfasalazine for 9 years, followed by infliximab and adalimumab for 10 months each
Summary
Crohn's disease is a chronic inflammatory gastrointestinal system disease of unknown etiology that causes deterioration in the patient's quality of life [1]. A chimeric immunoglobulin monoclonal antibody [anti-tumor necrosis factor alpha (anti-TNF-α)] drugs that neutralize the biological activity of TNF-α have revolutionized the treatment approach of inflammatory bowel disease (IBD) patients with severe or refractory disease in the last two decades [2,3,4]. These drugs pose a risk as a cause of triggering and/or emergence of various malignancies. We aimed to report a Philadelphia chromosome positive acute lymphoid leukemia [Ph (+) ALL] patient after the use of infliximab and azathioprine for the treatment of severe Crohn's disease After various anti-TNF-α treatments, hematological malignancies such as lymphoma, acute myeloid leukemia and fewer hematological malignancies such as acute lymphoid leukemia have been reported [5].
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