Secondary myelodysplastic syndrome following long-term treatment with azathioprine in patients with multiple sclerosis

Publication

Secondary myelodysplastic syndrome following long-term treatment with azathioprine in patients with multiple sclerosis

Journal Paper/Review - Jun 1, 2006

Putzki Norman, Knipp Sabine, Ramczykowski Tim, Vago Susanne, Germing Ulrich, Diener H Chr, Limmroth Volker

Units

Neurologie

PubMed

16764353

Citation

Putzki N, Knipp S, Ramczykowski T, Vago S, Germing U, Diener H, Limmroth V. Secondary myelodysplastic syndrome following long-term treatment with azathioprine in patients with multiple sclerosis. Multiple sclerosis (Houndmills, Basingstoke, England) 2006; 12:363-6.

Type

Journal Paper/Review (English)

Journal

Multiple sclerosis (Houndmills, Basingstoke, England) 2006; 12

Publication Date

Jun 1, 2006

Issn Print

1352-4585

Pages

363-6

Brief description/objective

Azathioprine (Aza) is a widely used immunosuppressive drug in multiple sclerosis (MS) treatment. Recently, the incidence of secondary myelodysplastic syndromes (sMDS) associated with a poor prognosis was found to be elevated in patients treated with Aza for non-malign disorders. Three hundred and seventeen MS patients were retrospectively analysed and complete blood counts were examined for those exposed to Aza. We identified one case of sMDS (cumulative dose 627 g) in a young patient and two further malignancies (cumulative doses 27 g and 54 g) in the Aza group (n = 81; 3.7%). In the non-Aza (n = 236) group, five malignancies (2.1%, P = 0.419) were identified. Including our patient, four cases of sMDS after long-term Aza therapy in MS have been reported so far. Cases suggest a time- and dose-dependent risk of sMDS in long-term therapy of MS with Aza. Long-term Aza therapy needs careful monitoring.