Volume 25, Issue 118, December 2021

The hidden truth about the development of myelodysplastic syndrome following immunosuppressant therapy for systemic sclerosis

Abishek Chakkravarthi M^1♦, Azeem I¹, Aswin Manikandan², Natarajan Suresh³

¹MD Second Year Pathology, Department of Pathology, Sree Balaji Medical College and Hospital, Chrompet, Chennai, Tamilnadu, India
²Senior Resident, Department of Pathology, Sree Balaji Medical College and Hospital, Chrompet, Chennai, Tamilnadu, India
³Associate Professor, Department of Pathology, Sree Balaji Medical College and Hospital, Chrompet, Chennai, Tamilnadu, India

^♦Corresponding author
MD Second Year Pathology, Department of Pathology, Sree Balaji Medical College and Hospital, Chrompet, Chennai, Tamilnadu, India

ABSTRACT

Many rheumatic conditions, including Systemic sclerosis, increase the risk of cancer. Solid tumours are most often found in the lungs, oesophagus, or breast. A higher risk of haematological cancers also associated with some DMARD therapeutic drug for systemic sclerosis. Myelodysplastic syndrome develops as a result of DMARD therapy used to treat systemic sclerosis, especially the drug azathioprine and cyclophosphamide, which has been linked to increase risk of developing myelodysplastic syndrome as compared to mycophenolate mofetil and methotrexate, according to reports. Another research found that a low dose of methotrexate can cause myelodysplastic syndrome in people with rheumatoid arthritis. There has been a rare reported case of myelodysplastic syndrome (MDS) secondary to Systemic sclerosis in some literature. Our goal is to raise concern about the growing prevalence of Myelodysplastic Syndrome in patients with Systemic Sclerosis that have been treated with azathioprine, cyclophosphamide and methotrexate, as was the scenario in our case.

Keywords: Sclerosis; Azathioprine; Myelodysplastic; Methotrexate; Haemopoietic tissue.

Medical Science, 2021, 25(118), 3557-3561

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