Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Correspondence
  • Published:

A case of refractory anemia with 17p− syndrome following azathioprine treatment for heart transplantation

Leukemia volume 18, page 878 (2004)Cite this article

TO THE EDITOR

Azathioprine is an antimetabolite drug widely used for immunosuppression in post-transplantation regimen and various autoimmune disorders. Although azathioprine commonly produces a variety of hematological abnormalities, including megaloblastic changes and marrow suppression, the incidence of therapy-related myelodysplastic syndromes (t-MDS) or acute myeloid leukemia (AML) is admittedly very low. However, a few cases of t-MDS or AML following prolonged azathioprine treatment have been reported.1,2,3,4,5 When available, cytogenetic analysis showed mainly 5 and 7 abnormalities. The 17p− syndrome represents a morphological–cytogenetic entity among MDS characterized by a specific type of dysgranulopoiesis and P53 mutation. About one-half of cases occur after prolonged use of alkylating agents and generally carry −7/del 7q. The other half occur after essential thrombocythemia and polycythemia vera treated by hydroxyurea or other nonalkylating agents, and usually have no −7/del 7q.6 We describe here a case of therapy-related refractory anemia following long-term azathioprine treatment with 17p− syndrome and cytogenetic abnormalities revealed by conventional karyotype and multiplex fluorescent in situ hybridization.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

References

  1. Kwong YL, Au WY, Liang RH . Acute myeloid leukemia after azathioprine treatment for autoimmune diseases: association with −7/7q. Cancer Genet Cytogenet 1998; 104: 94–97.

    Article  CAS  Google Scholar 

  2. Huebner G, Karthaus M, Pethig K, Freund M, Ganser A . Myelodysplastic syndrome and acute myelogenous leukemia secondary to heart transplantation. Transplantation 2000; 70: 688–690.

    Article  CAS  Google Scholar 

  3. Krishnan K, Adams P, Silveira S, Sheldon S, Dabich L . Therapy-related acute myeloid leukaemia following immunosuppression with azathioprine for polymyositis. Clin Lab Haematol 1994; 16: 285–289.

    Article  CAS  Google Scholar 

  4. Mok CC, Kwong YL, Lau CS . Secondary acute myeloid leukaemia with 7q− complicating azathioprine treatment for rheumatoid arthritis. Ann Rheum Dis 1995; 54: 155–156.

    Article  CAS  Google Scholar 

  5. Arnold JA, Ranson SA, Abdalla SH . Azathioprine-associated acute myeloid leukaemia with trilineage dysplasia and complex karyotype: a case report and review of the literature. Clin Lab Haematol 1999; 21: 289–292.

    Article  CAS  Google Scholar 

  6. Merlat A, Lai JL, Sterkers Y, Demory JL, Bauters F, Preudhomme C, Fenaux P . Therapy-related myelodysplastic syndrome and acute myeloid leukemia with 17p deletion. A report on 25 cases. Leukemia 1999; 13: 250–257.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Service des Maladies du Sang, CHU de Lille, France

    S Depil & B Quesnel

  2. Laboratoire d'Hématologie, CHU de Lille, France

    P Lepelley, V Soenen & C Preudhomme

  3. Laboratoire de Cytogénétique, CHU de Lille, France

    J L Lai

  4. Laboratoire de Biochimie et de Biologie Moléculaire, CHU de Lille, France

    F Broly

Authors
  1. S Depil
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. P Lepelley
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. V Soenen
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. C Preudhomme
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. J L Lai
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. F Broly
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. B Quesnel
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to B Quesnel.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Depil, S., Lepelley, P., Soenen, V. et al. A case of refractory anemia with 17p− syndrome following azathioprine treatment for heart transplantation. Leukemia 18, 878 (2004). https://doi.org/10.1038/sj.leu.2403305

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.leu.2403305

Search

Advanced search

Quick links