건선관절염을 동반한 건선 환자에서 adalimumab 치료 중 발생한 급성골수성백혈병 1예 (A case of acute myeloid leukemia during adalimumab treatment in a patient with psoriatic arthritis)

서지정보

· 발행기관 : 대한건선학회
· 수록지 정보 : 대한건선학회지 / 15권 / 2호 / 59 ~ 61페이지
· 저자명 : 석승휘, 안지혜, 이선구, 이희정, 윤문수, 김동현

초록

Adalimumab, a fully human anti-tumor necrosis factor-alpha (TNF-α) monoclonal antibody, which has been successfully used in the treatment of several immune-mediated disorders including psoriasis. Hematologic malignancies or lymphoproliferative disorders associated with the use of TNF-α inhibitors in psoriatic patients have been reported.
A 62 years-old male patient presented with plaque psoriasis for 20 years’ duration. Although he had received narrowband ultraviolet B phototherapy for 3 years and oral methotrexate for 6 months, none of them were satisfactory. The patient also complained of pain in multiple joints and onycholysis.
Psoriatic arthritis was diagnosed based on the Classification criteria for psoriatic arthritis (CASPAR). He started to receive the treatment of subcutaneous injection of adalimumab 40 mg according to the dosing schedule of plaque psoriasis. During loading dose and initial six months, psoriatic skin lesion and arthralgia improved gradually. After 16 injections of adalimumab, the patient complained of myalgia, headache, and fatigue.
Blood tests showed marked leukocytosis, anemia and low platelet counts, and the blast count was 45%. The patient was diagnosed with acute myeloid leukemia (AML) by additional bone marrow tests.
Herein, we report a case of AML during the treatment with adalimumab to raise the awareness of the rare possibility of hematologic malignancy.
Key Words: Adalimumab, Leukemia

영어초록

Adalimumab, a fully human anti-tumor necrosis factor-alpha (TNF-α) monoclonal antibody, which has been successfully used in the treatment of several immune-mediated disorders including psoriasis. Hematologic malignancies or lymphoproliferative disorders associated with the use of TNF-α inhibitors in psoriatic patients have been reported.
A 62 years-old male patient presented with plaque psoriasis for 20 years’ duration. Although he had received narrowband ultraviolet B phototherapy for 3 years and oral methotrexate for 6 months, none of them were satisfactory. The patient also complained of pain in multiple joints and onycholysis.
Psoriatic arthritis was diagnosed based on the Classification criteria for psoriatic arthritis (CASPAR). He started to receive the treatment of subcutaneous injection of adalimumab 40 mg according to the dosing schedule of plaque psoriasis. During loading dose and initial six months, psoriatic skin lesion and arthralgia improved gradually. After 16 injections of adalimumab, the patient complained of myalgia, headache, and fatigue.
Blood tests showed marked leukocytosis, anemia and low platelet counts, and the blast count was 45%. The patient was diagnosed with acute myeloid leukemia (AML) by additional bone marrow tests.
Herein, we report a case of AML during the treatment with adalimumab to raise the awareness of the rare possibility of hematologic malignancy.
Key Words: Adalimumab, Leukemia

참고자료

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