Abstract
In a review of a large number of patients with inflammatory bowel disease, leukemia was observed in five patients with chronic ulcerative colitis and in two patients with Crohn's disease. In ulcerative colitis patients, there were three cases of acute myelocytic leukemia and one case each of acute lymphoblastic leukemia and chronic granulocytic leukemia. In Crohn's disease patients, there was one case each of chronic granulocytic leukemia and chronic lymphocytic leukemia associated with thrombocythemia. Sixteen other cases of leukemia have been reported to date in inflammatory bowel disease. All types of leukemia, but particularly acute myelocytic leukemia, have been described. There has been no single common feature as to type (whether ulcerative colitis or Crohn's disease), extent and course, or medical and surgical treatment of the bowel disease. The relative risk of leukemia in patients with ulcerative colitis was 5.3 [95% confidence interval 1.7 to 12.3 (P<0.01)] and of acute myelocytic leukemia 11.4 [95% confidence interval 2.3 to 24.9 (P<0.01)]. Our data on patients with Crohn's disease were not sufficient to assess the statistical significance of leukemia in this disease. This study suggests that there may be an increased risk of leukemia, particularly acute myelocytic leukemia, in ulcerative colitis. The causal relationship, if any, remains undetermined.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
Dobbins WO III: Dysplasia and malignancy in inflammatory bowel disease. Annu Rev Med 35:33–48, 1984
Weedon DD, Shorter RG, Ilstrup DM, Huizenga KA, Taylor WF: Crohn's disease and cancer. N Engl J Med 289: 1099–1102, 1973
Gyde SN, Prior P, Macartney JC, Thompson H, Waterhouse JA, Allan RN: Malignancy in Crohn's disease. Gut 21:1024–1029, 1980
Greenstein AJ, Sachar DB, Smith H, Janowitz HD, Aufses AH Jr: Pattern of neoplasia in Crohn's disease and ulcerative colitis. Cancer 46:403–407, 1980
Prior P, Gyde SN, Macartney JC, Thompson H, Waterhouse JAH, Allan RN: Cancer morbidity in ulcerative colitis. Gut 23:490–497, 1982
Ritchie JK, Allan RN, Macartney J, Thompson H, Hawley PR, Cooke WT: Biliary tract carcinoma associated with ulcerative colitis. Q J Med 43:263–279, 1974
Adelsberg R: Kaposi's sarcoma complicating ulcerative colitis: Report of a case. Am J Clin Pathol 54:143–146, 1970
Smith PM: Hepatoma associated with ulcerative colitis. Report of a case. Dis Colon Rectum 17:554–556, 1974
Katz J, Savin R, Spiro HM: The basal cell nevus syndrome and inflammatory disease of the bowel. Am J Med 44:483–488, 1968
Kirk BW, Freedman SO: Hypogammaglobulinemia, thymoma and ulcerative colitis. Can Med Assoc J 96:1272–1277, 1967
Emanuel JC, Isbister WH: Chronic mucosal ulcerative colitis with malignant lymphoma. Report of a case. Aust NZ J Surg 49:95–98, 1979
Glick SN, Teplick ST, Goodman LR, Clearfield HR, Shanser JD: Development of lymphoma in patients with Crohn's disease. Radiology 153:337–339, 1984
Shaw JHF, Mulvaney N: Hodgkin's lymphoma: A complication of small bowel Crohn's disease. Aust NZ J Surg 52:34–36, 1982
Morrison PD, Whittaker M: A case of Hodgkin's disease complicating Crohn's disease. Clin Oncol 8:271–272, 1982
Fabry TL, Sachar DB, Janowitz HD: Acute myelogenous leukemia in patients with ulcerative colitis. J Clin Gastroenterol 2:225–227, 1980
Cuttner J: Increased incidence of acute promyelocytic leukemia in patients with ulcerative colitis. Ann Intern Med 97:864–865, 1982
Hanauer SB, Wong KK, Frank PH, Sweet DL, Kirsner JB: Acute leukemia following inflammatory bowel disease. Dig Dis Sci 27:545–548, 1982
Cohn EM, Pearlstine B: Inflammatory bowel disease and leukemia. J Clin Gastroenterol 6:33–35, 1984
Giron JA, Yebra M, Solovera JJ, Abreu L, Diego J, Bonilla F, Durantez A: Crohn's disease and leukemia. Dig Dis Sci 30:410–411, 1985
Third National Cancer Survey: Incidence Data. U.S. Department of Health, Education, and Welfare. National Cancer Institute Monograph 41, March 1975
Grünwald HW, Rosner F: Acute leukemia and immunosuppressive drug use. A review of patients undergoing immunosuppressive therapy for non-neoplastic disease. Arch Intern Med 139:461–466, 1979
Brill AB, Tomonaga M, Heyssel RM: Leukemia in man following exposure to ionizing radiation: A summary of the findings in Hiroshima and Nagasaki and a comparison with other human experience. Ann Intern Med 56:590–609, 1962
Stewart A, Pennybacker W, Barber R: Adult leukemia and diagnostic x-rays. Br Med J 2:882–890, 1962
Gibson R, Graham S, Lilienfeld A, Schuman L, Dowd JE, Levin ML: Irradiation in the epidemiology of leukemia among adults. J Natl Cancer Inst 48:301–311, 1972
Court-Brown WM, Albatt JD: The incidence of leukemia in ankylosing spondylitis treated with x-rays. Lancet 1:1283–1285, 1955
Rogers AG, Faintuch J, Sourkes AN, Cormack DV: Diagnostic radiation—a possible factor in malignancy in patients with chronic inflammatory bowel disease. Gastroenterology 75:345, 1978 (letter)
Linos A, Gray JE, Orvis AL, Kyle RA, O'Fallon WM, Kurland LT: Low-dose radiation and leukemia: N Engl J Med 302:1101–1105, 1980
Boice JD: Cancer following medical irradiation. Cancer 47:1081–1090, 1981
Greenberg MS, Anderson KC, Marchetto DJ, Li FP: Acute myelocytic leukemia in two brothers with polyposis coli and carcinoma of the colon. Ann Intern Med 95:702–703, 1981
Henderson ES: Acute leukemia.In Hematology, 3rd ed, WJ Williams, E Beutler, AJ Erslev, MA Lichtman, (eds). New York, McGraw-Hill, 1983, pp 221–227
Sachar DB, Auslander MO, Walfish JS: Aetiological theories of inflammatory bowel disease. Clin Gastroenterol 9:231–257, 1980
Kirsner JB, Shorter RG: Recent development in nonspecific inflammatory bowel disease. N Engl J Med 306:837–848, 1982
Morowitz DA, Allen LW, Kirsner JB: Thrombocytosis in chronic inflammatory bowel disease. Ann Intern Med 68:1013–1021, 1968
Talstad I, Rootwelt K, Gjone E: Thrombocytosis in ulcerative colitis and Crohn/s disease. Scand J Gastroenterol 8:135–138, 1973
Manusow D, Weinerman BH: Subsequent neoplasia in chronic lymphocytic leukemia. JAMA 232:267–269, 1975
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Madjlessi, S.H.M., Farmer, R.G. & Weick, J.K. Inflammatory bowel disease and leukemia. Digest Dis Sci 31, 1025–1031 (1986). https://doi.org/10.1007/BF01300254
Received:
Revised:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01300254