Colchicine
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First report of acute promyelocytic leukaemia: case report A 34-year-old man developed acute promyelocytic leukaemia while receiving colchicine for Behcet’s syndrome. The man, who had been receiving colchicine [Colchicum Dispert] 1 mg/day for 12 years, was hospitalised with leucopenia, anaemia and haemorrhagic diathesis. On presentation, he reported a decrease in exercise capacity and haematuria. Over the past 2 weeks, his symptoms had progressively worsened. A physical examination showed aphthous ulcerations on his buccal mucosa, paleness of his skin, pustular lesions on his buttocks and generalised ecchymoses. His spleen was palpable 3cm below his ribs. Laboratory testing revealed the following: haemoglobin 8.2 g/dL, WBC count 1.4 x 109/L with absolute neutrophil count 0.1 x 109/L, platelet count 28 x 109/L, erythrocyte sedimentation rate 50 mm/h, C-reactive protein 42 mg/dL, α2-globulin 5.2%, C3 150.3 mg/dL and serum albumin 4.5 g/dL. Myeloperoxidase activity and a peripheral blood smear and bone marrow sample with CD 13 and 33-positive promyelocytic leucocytes led to a diagnosis of acute promyelocytic leukaemia. Fluorescent in situ hybridisation of cultured bone marrow lymphocytes with the t(15;17) probe showed translocation-positive signals. The man began receiving tretinoin and idarubicin. Within 30 days, he showed a complete haematologic and cytogenetic remission of disease. For the following 18 months, he received methotrexate and mercaptopurine, and haematologic remission persisted. Author comment: "In our patient, long-term treatment with colchicine probably resulted in acute promyelocytic leukemia." Ozdogu H, et al. Long-term colchicine therapy in a patient with Behcet’s disease and acute promyelocytic leukemia. Rheumatology International 27: 763-765, No. 801081821 8, Jun 2007 - Turkey
» Editorial comment: A search of AdisBase and Medline did not reveal any previous case reports of acute promyelocytic leukaemia associated with colchicine. Acute promyelocytic leukaemia was not found in the WHO Adverse Reactions Terminology. However, the database contained one report of granulocytic leukaemia associated with colchicine.
0114-9954/10/1162-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
Reactions 28 Jul 2007 No. 1162
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