Acute myeloblastic leukemia following prolonged treatment of Crohn's disease with 6-mercaptopurine

Dig Dis Sci. 1998 Aug;43(8):1791-3. doi: 10.1023/a:1018896006155.


A 65-year-old man with Crohn's disease died of acute myeloblastic leukemia after treatment for 11.8 years with 6-mercaptopurine, 1.5 mg/kg/day (100 mg/day). On cytogenetic analysis, most of the malignant bone marrow cells had deletion of chromosome 7, the most frequently reported cytogenetic abnormality in chemotherapy-related acute leukemia. This finding, together with previous reports of acute leukemia and other malignancies following prolonged treatment with azathioprine or 6-mercaptopurine for nonmalignant conditions including inflammatory bowel disease, indicates that long-term use of these drugs for inflammatory bowel disease may increase the risk of malignancy. However, the magnitude of the risk is unknown.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Chromosome Deletion
  • Chromosomes, Human, Pair 7 / genetics
  • Crohn Disease / drug therapy*
  • Humans
  • Immunosuppressive Agents / adverse effects*
  • Immunosuppressive Agents / therapeutic use
  • Leukemia, Myeloid, Acute / chemically induced*
  • Leukemia, Myeloid, Acute / genetics
  • Male
  • Mercaptopurine / adverse effects*
  • Mercaptopurine / therapeutic use


  • Immunosuppressive Agents
  • Mercaptopurine