Last update:
28-Jul-2000

Arch Hellen Med, 16(6), November-December 1999, 604–606

SHORT COMMUNICATION

Early diagnosis of colon cancer after administration of 2-chlorodeoxyadenosine in a patient with chronic lymphocytic leukemia

K.H. KATSANOS, P. KAIAFAS, K.L. BOURANTAS
University Hospital of Ioannina, Greece

The case is presented of a 72 year old male patient with chronic lymphocytic leukemia (CLL) diagnosed 2 years earlier and treated with methylprednisolone and chlorambucil. Colon diverticulosis had been diagnosed ten years previously. Two months before admission he was started on, and responded to, 2-chlorodeoxyadenosine (2-CdA) because of a CLL aberration of polymorphocytic (PL) leukemia, and he achieved complete remission. Two months later the patient was admitted because of lower gastrointestinal tract bleeding. Colonoscopy revealed a transverse colon adenocarcinoma, Dukes stage I. A routine colonoscopy performed 2 months before 2-CdA administration had been negative. Surgical intervention was successful and the patient is living in hematologic remission. If it is accepted that the diagnosis of colon cancer in this patient 2 months after 2-CdA administration was not a simple coincidence, and bearing in mind that hematologic malignancies often coexist with other malignancies, it could be considered, with reservations, that this case is a model explaining the possible in vivo action of nucleoside analogues and specifically of 2-CdA. This hypothetical in vivo mechanism could be based on the contribution of nucleoside analogues and nucleoside transporters in increasing or in not down-regulating apoptosis of the bowel epithelium. However the central theory that one malignancy in this case (CLL) can trigger another (colon cancer) remains.

Key words: Apoptosis, Bowel cancer, Chronic lymphocytic leukemia, 2-deoxychloroadenosine.