J Rheum Dis.  2012 Apr;19(2):91-94. 10.4078/jrd.2012.19.2.91.

A Case of Acute Myeloid Leukemia after Adalimumab Treatment in Psoriatic Arthritis

• Min HK
• Lee JH
• Lee HM
• Koh E
• Heo JY
• Min JK
• Park SH

• KMID: 2223106
• DOI: http://doi.org/10.4078/jrd.2012.19.2.91

Abstract

Hematologic malignancies and lymphoproliferative disorders have been reported after using tumor necrosis factor-alpha inhibitor in patients suffering from spondyloarthropathy. Previously reported cases were treated by using infliximab and etanercept. Usually, it takes approximately several months for leukemia or lymphoproliferative disorders to occur after the application of those agents. However, we report a case of acute myeloid leukemia that developed after short term usage of adalimumab in a patient suffering from psoriatic arthritis.

Keyword

Psoriatic arthritis; Acute myeloid leukemia; Adalimumab

MeSH Terms

Antibodies, Monoclonal
Antibodies, Monoclonal, Humanized
Arthritis, Psoriatic
Hematologic Neoplasms
Humans
Immunoglobulin G
Leukemia
Leukemia, Myeloid, Acute
Lymphoproliferative Disorders
Receptors, Tumor Necrosis Factor
Spondylarthropathies
Stress, Psychological
Tumor Necrosis Factor-alpha
Adalimumab
Infliximab
Etanercept
Antibodies, Monoclonal
Antibodies, Monoclonal, Humanized
Immunoglobulin G
Receptors, Tumor Necrosis Factor
Tumor Necrosis Factor-alpha

Figure

• 

  Figure 1 Bone scan shows multiple enthesopathy at the site of the left elbow, the lesser trochanters of both femurs, the right knee, and both ankles. Sacroiliac joint plain film indicates minimal sclerosis on the left upper side (white arrow). However, there was no definite joint space widening or erosion.

• 

  Figure 2 Bone marrow biopsy (A, 100×) and smear (B, 1,000×) were derived from the posterior superior iliac spine. As a result, the bone marrow biopsy showed 80% cellularity (A). Bone marrow smear shows cluster of leukemic cells (B).

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  Figure 3 Chromosome study demonstrates translocation between the short arm of chromosome 6 and the long arm of chromosome 9, and translocation between the short arm of chromosome 10 and the short arm of chromosome 16.

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