Cases of acute leukaemia following immunosuppressive therapy for disseminated sclerosis and for Behçet's syndrome
Mougeot-Martin, M.; Krulik, M.; Harousseau, J.L.; Audebert, A.A.; Chaouat, Y.; Debray, J.
Annales de Medecine Interne 129(3): 175-180
1978
ISSN/ISBN: 0003-410X PMID: 655513 Document Number: 138964
On the basis of two personal cases of acute leukaemia occurring following immunosuppressive therapy for disseminated sclerosis and for Behçet's syndrome, the literature is reviewed. Thirty three similar detailed cases were collected. They are characterised in general by the prolonged use of immunosuppression. The acute leukaemia affected the granulocyte series in the majority of cases. In 30%; the leukaemia was preceded by a phase of several months of preleukaemic type dysmyelopoiesis. The mechanisms of action explaining this carcinogenic risk in a general way are multiple: the role of marrow aplasia, chromosomal abnormalities, the activation of a leukaemogenic virus, the role of immunodepression and that of repeated antigenic stimulation may all be discussed. The risks associated with such treatment should thus be borne in mind when evaluating its indications.