Gastrointestinal Behcet's-like disease with myelodysplastic neoplasms with trisomy 8: a French case series and literature review

Leuk Lymphoma. 2019 Jul;60(7):1782-1788. doi: 10.1080/10428194.2018.1542152. Epub 2018 Nov 20.

Abstract

We report the 11 cases of +8-MDS/MPN associated with Behcet's-like syndrome and compare them with Behcet's disease and Crohn's disease, pool with literature cases for analysis. Data for patients with +8-MDS/MPN and Behçet's-like syndrome were collected from MINHEMON. Eleven patients had Behcet's-like syndrome and +8-MDS/MPN (median age 75 years [IQR 65-87]; M/F ratio 0.8). MDS and Behcet's-like syndrome were diagnosed at the same time (7/11, 64%). By comparison with 63 patients with idiopathic Behcet's disease without associated MDS, those with Behcet's-like syndrome and +8-MDS/MPN were older (median 75 vs 48 years; p = .0003) and had less pseudofolliculitis (11% vs 62%; p = .0045) and ocular impairment (0% vs 52%; p = .0008), but more frequent gastrointestinal involvement (60% vs 13%; p = .0005). By comparison with Crohn's disease, 39 patients with Behcet's-like syndrome and +8-MDS/MPN were significantly older (median 72 [53-78] vs 36 [27-45] years; p = .0002) and more frequently had oral aphtosis (97% vs 5%, p < .0001), skin features (50% vs 10%, p = .0005) and arthralgia (63% vs 20%, p = .03). Median survival did not differ between patients with Behcet's-like syndrome and +8-MDS/MPN and those with +8-MDS/MPN (n = 103) (47 vs 34 months, p = .61). AML-free survival did not differ between patients with MDS/MPN with and without Behcet's-like syndrome (p = .29). MDS/MPN with trisomy 8 can be associated with particular phenotype of ulcerative digestive disease resembling Behcet's or Crohn's disease and should be considered a single disease.

Keywords: Behcet’s disease; outcome; treatment; trisomy 8-positive myelodysplastic syndrome.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Behcet Syndrome / complications
  • Behcet Syndrome / diagnosis*
  • Behcet Syndrome / genetics
  • Chromosomes, Human, Pair 8 / genetics
  • Diagnosis, Differential
  • Female
  • Follow-Up Studies
  • Gastrointestinal Diseases / complications
  • Gastrointestinal Diseases / diagnosis*
  • Gastrointestinal Diseases / genetics
  • Humans
  • Male
  • Middle Aged
  • Myelodysplastic Syndromes / complications
  • Myelodysplastic Syndromes / diagnosis*
  • Myelodysplastic Syndromes / genetics
  • Myelodysplastic-Myeloproliferative Diseases / complications
  • Myelodysplastic-Myeloproliferative Diseases / diagnosis*
  • Myelodysplastic-Myeloproliferative Diseases / genetics
  • Prognosis
  • Trisomy / diagnosis*
  • Trisomy / genetics

Supplementary concepts

  • Chromosome 8, trisomy