Thiopurines and myeloid disorders: is more caution needed when treating inflammatory bowel disease patients?

Thiopurines remain the backbone therapy of inflammatory bowel diseases (IBD). However, these drugs have potential mutagenic and carcinogenic effects, especially when prescribed for a long time. In addition to the increased risk of lymphoma and non-melanoma skin cancer, recent data suggest that risk of myeloid disorder is increased in IBD patients with past exposure to thiopurines. Even if individual risk is low, practitioners who take care of IBD patients should be aware of this potential complication of thiopurines treatment.