mercaptopurine and Tuberculosis--Pulmonary

We report a rare case of hypercalcemia and acute pancreatitis in a subject with acute promyelocytic leukemia (APL) and pulmonary tuberculosis, during all-trans-retinoic acid (ATRA) treatment. Both associated complications were potentially due to several causes. A careful monitoring and exclusion of all causative factors must be addressed. Further research is necessary to improve our understanding of risk factors for these complications in patients with (APL). Studying these patterns may help us to improve outcomes for all children and young adults with hematologic malignancies.

Topics: Acute Disease; Antineoplastic Combined Chemotherapy Protocols; Asparaginase; Causality; Febrile Neutropenia; Humans; Hypercalcemia; Leukemia, Promyelocytic, Acute; Male; Mercaptopurine; Methotrexate; Middle Aged; Models, Biological; Pancreatitis; Pleural Effusion; Prednisone; Pulmonary Aspergillosis; Risk Factors; Tretinoin; Tuberculosis, Pulmonary; Vincristine

The aims of this study were to assess the risk of tuberculosis (TB) and the status of latent tuberculosis infection (LTBI) in Korean patients with inflammatory bowel disease (IBD) receiving tumor necrosis factor (TNF)-α blockers. We reviewed medical records of 525 Korean IBD patients (365 TNF-α blocker naïve and 160 TNF-α blocker exposed) between January 2001 and December 2013. The crude incidence of TB was significantly higher in IBD patients receiving TNF-α blockers compared to TNF-α-blocker-naïve patients (3.1% vs. 0.3%, P=0.011). The mean incidence of TB per 1,000 patient-years was 1.84 for the overall IBD population, 4.89 for TNF-α blocker users, and 0.45 for TNF-α-blocker-naïve patients. The adjusted risk ratio of TB in IBD patients receiving TNF-α blocker was 11.7 (95% confidence interval, 1.36-101.3). Pulmonary TB was prevalent in patients treated with TNF-α blockers (80.0%, 4/5). LTBI was diagnosed in 17 (10.6%) patients, and none of the 17 LTBI patients experienced reactivation of TB during treatment with TNF-α blockers. Treatment with TNF-α blockers significantly increased the risk of TB in IBD patients in Korea. De novo pulmonary TB infection was more prevalent than reactivation of LTBI, suggesting an urgent need for specific recommendations regarding TB monitoring during TNF-α blocker therapy.

Topics: Adult; Anti-Inflammatory Agents, Non-Steroidal; Antibodies, Monoclonal; Cohort Studies; Colitis, Ulcerative; Crohn Disease; Female; Humans; Infliximab; Latent Tuberculosis; Male; Mercaptopurine; Mycobacterium tuberculosis; Republic of Korea; Retrospective Studies; Tuberculosis, Pulmonary; Tumor Necrosis Factor-alpha

Topics: Antineoplastic Agents, Phytogenic; Antineoplastic Combined Chemotherapy Protocols; Antitubercular Agents; Chemical and Drug Induced Liver Injury; Child, Preschool; Cytarabine; Humans; Injections, Intramuscular; Injections, Spinal; Male; Mercaptopurine; Methotrexate; Precursor Cell Lymphoblastic Leukemia-Lymphoma; Prednisolone; Remission Induction; Tuberculosis, Pulmonary; Vincristine

Topics: Animals; Cyclophosphamide; Hydrocortisone; Leukocyte Count; Lymphoid Tissue; Mercaptopurine; Methotrexate; Rabbits; T-Lymphocytes; Tuberculosis, Pulmonary

A greek boy is described in whom pulmonary tuberculosis and homozygous beta-thalassemia was discovered at 4 years of age. Tuberculosis was cured after 1 year of combined tuberculostatic chemotherapy. His thalassemia only required 1-2 blood transfusions per year. Acute lymphoblastic leukemia was diagnosed in the patient at 8 years of age and treated with antileukemic combination chemotherapy and cranial irradiation. 7 months after diagnosis the boy is still in continuous complete remission under antileukemic chemotherapy without requiring blood transfusions.

Topics: Blood Transfusion; Child; Cyclophosphamide; Drug Therapy, Combination; Germany, West; Greece; Humans; Leukemia, Lymphoid; Male; Mercaptopurine; Methotrexate; Prednisone; Remission, Spontaneous; Skull; Thalassemia; Time Factors; Tuberculosis, Pulmonary; Vincristine

Topics: Animals; Azathioprine; Cyclophosphamide; Dactinomycin; Fluorouracil; Immunosuppressive Agents; Mercaptopurine; Methotrexate; Rabbits; Tuberculosis, Pulmonary

Topics: Alkylating Agents; Aminopterin; Busulfan; Hodgkin Disease; Humans; Leukemia; Leukemia, Lymphoid; Leukemia, Myeloid; Lymphoma; Lymphoma, Large B-Cell, Diffuse; Lymphoma, Non-Hodgkin; Mechlorethamine; Mercaptopurine; Methotrexate; Multiple Myeloma; Neoplasms; Pathology; Primary Myelofibrosis; Sarcoma; Triethylenemelamine; Tuberculosis; Tuberculosis, Pulmonary; Urethane