{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,8]],"date-time":"2025-11-08T22:15:21Z","timestamp":1762640121312,"version":"3.44.0"},"reference-count":18,"publisher":"BMJ","issue":"10","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2023,9,19]]},"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:p>The US Food and Drug Administration has approved TNF(Tumor necrosis factor) alpha inhibitors to manage a range of inflammatory conditions, including Crohn\u2019s disease, rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis and other inflammatory disorders. However, these inhibitors can potentially increase the risk of secondary blood malignancies due to TNF alpha\u2019s role in various cellular processes such as angiogenesis, cell cycle proliferation, apoptosis and differentiation. In this article, we present a unique case study of a patient who developed Philadelphia-positive acute lymphoblastic leukaemia (ALL) while receiving adalimumab, a potent monoclonal antibody that specifically binds to TNF-alpha. We describe the patient\u2019s successful treatment using standard-of-care chemotherapy and tyrosine kinase inhibitors, resulting in complete remission with no measurable residual disease. Furthermore, we conducted a literature review on this subject and identified five similar cases of ALL associated with TNF alpha inhibitors.<\/jats:p>","DOI":"10.1136\/bcr-2023-255604","type":"journal-article","created":{"date-parts":[[2023,10,25]],"date-time":"2023-10-25T03:25:35Z","timestamp":1698204335000},"page":"e255604","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Adalimumab-associated Philadelphia chromosome positive acute lymphoblastic leukaemia in a patient with Crohn\u2019s disease"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-8641-5587","authenticated-orcid":false,"given":"Vishal","family":"Devarkonda","sequence":"first","affiliation":[{"name":"LSU Health Shreveport School of Medicine, Shreveport, Louisiana, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shravya","family":"Balmuri","sequence":"additional","affiliation":[{"name":"LSU Health Shreveport School of Medicine, Shreveport, Louisiana, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Antonia Costa Cruz","family":"Akabane","sequence":"additional","affiliation":[{"name":"Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-0528-1006","authenticated-orcid":false,"given":"Hugo","family":"Akabane","sequence":"additional","affiliation":[{"name":"LSU Health Shreveport School of Medicine, Shreveport, Louisiana, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2023,10,24]]},"reference":[{"key":"2025082622380016000_16.10.e255604.1","first-page":"413","article-title":"Clinical significance and management of MRD in adults with acute lymphoblastic leukemia","volume":"18","author":"Akabane","year":"2020","journal-title":"Clin Adv Hematol Oncol"},{"key":"2025082622380016000_16.10.e255604.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.idc.2010.01.006"},{"key":"2025082622380016000_16.10.e255604.3","doi-asserted-by":"publisher","DOI":"10.1634\/theoncologist.11-4-397"},{"key":"2025082622380016000_16.10.e255604.4","unstructured":"FDA alert . Tumor necrosis factor (TNF) blockers (marketed as Remicade, Enbrel, Humira, Cimzia, and Simponi), Available: http:\/\/www.fda.gov\/Drugs\/DrugSafety\/PostmarketDrug Safety Information for Patients and Providers\/Drug Safety Information for Heathcare Professionals\/ucm174474.htm"},{"key":"2025082622380016000_16.10.e255604.5","doi-asserted-by":"publisher","DOI":"10.1186\/s13075-015-0728-9"},{"key":"2025082622380016000_16.10.e255604.6","doi-asserted-by":"publisher","DOI":"10.3390\/ijms22052719"},{"key":"2025082622380016000_16.10.e255604.7","unstructured":"Valerie G , Amandeep G , Karam K . Tumor necrosis factor inhibitors. In: StatPearls [Internet]. 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Acute lymphoid leukemia after anti-TNF-alpha treatment: a case report and review of the literature; 2015."}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2023-255604","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T05:38:11Z","timestamp":1756273091000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2023-255604"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,10]]},"references-count":18,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2023,10,24]]},"published-print":{"date-parts":[[2023,10]]}},"alternative-id":["10.1136\/bcr-2023-255604"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2023-255604","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2023,10]]}}}