THE ASSOCIATION OF INFLAMMATORY BOWEL-DISEASE AND LEUKEMIA - COINCIDENCE OR NOT

Inflammatory bowel diseases, (IBD) including Crohn's disease and ulcer ative colitis, are chronic systemic disorders associated with intestin al and other systemic features. Common hematological manifestations of IBD include: anemia, hypercoagulable state, leukocytosis and thromboc ytosis. Recently it has been recognized that lymphoma and leukemia can also be associated with both Crohn's disease and ulcerative colitis. Careful review of the literature reveals more than 30 cases of leukemi a reported in patients with IBD. Epidemiological data show that this a ssociation is statistically significant (relative risk of 5.3; p < 0.0 1; 95% confidence interval). This review attempts to characterize the clinical features of this association. The etiology of leukemia in the se cases seems to be multifactorial and may involve: genetic susceptib ility, environmental factors, immune abnormalities, prior exposure to diagnostic radiation and a variety of therapeutic modalities. No defin itive time interval, specific pattern or correlation between the exten t of bowel involvement and type of leukemia was found. Treatment of le ukemia might affect the activity and severity of the inflammatory bowe l disease, but there is very little data relating to this issue. There is some evidence suggesting that bone marrow transplantation performe d for leukemia may induce remission of both diseases. Further investig ation is still required in the future in order to establish a definite relationship between these two disorders.