TY - JOUR
T1 - Lymphoma and IBD
T2 - What is the actual risk?
AU - De Chambrun, Guillaume Pineton
AU - Peyrin-Biroulet, Laurent
AU - De Vroey, Béńedicte
AU - Colombel, Jean Fred́éric
PY - 2011
Y1 - 2011
N2 - With the increased use of immunosuppressive and biological agents for the treatment of IBD, the risk of serious side effects, especially lymphoma, has become a major concern for clinicians managing patients with Crohn's disease and ulcerative colitis. When used for organ transplantation, immunosuppressive drugs have been clearly associated with an increased risk of lymphoma. In IBD, the possible role of thiopurines and anti-tumor necrosis factor (anti-TNF) agents in lymphomagenesis is difficult to determine because of the lower doses of drugs used and the potential role of the underlying inflammatory disease. However, large, population-based studies have demonstrated that the risk of lymphoma in the general IBD population seems to be similar to or only slightly higher than that in the general population. Available results from population-based studies and meta-analyses suggest that anti-TNF agents are not associated with an increased risk of lymphoma whereas thiopurines moderately increase this risk in IBD patients. These considerations, as well as the recently identified risk of fatal hepatosplenic T cell lymphoma in young male patients with IBD receiving co-treatment with anti-TNF agents and thiopurines, need to be incorporated into clinical practice in order to decide which treatment will be the most efficient - and also the safest - for each patient.
AB - With the increased use of immunosuppressive and biological agents for the treatment of IBD, the risk of serious side effects, especially lymphoma, has become a major concern for clinicians managing patients with Crohn's disease and ulcerative colitis. When used for organ transplantation, immunosuppressive drugs have been clearly associated with an increased risk of lymphoma. In IBD, the possible role of thiopurines and anti-tumor necrosis factor (anti-TNF) agents in lymphomagenesis is difficult to determine because of the lower doses of drugs used and the potential role of the underlying inflammatory disease. However, large, population-based studies have demonstrated that the risk of lymphoma in the general IBD population seems to be similar to or only slightly higher than that in the general population. Available results from population-based studies and meta-analyses suggest that anti-TNF agents are not associated with an increased risk of lymphoma whereas thiopurines moderately increase this risk in IBD patients. These considerations, as well as the recently identified risk of fatal hepatosplenic T cell lymphoma in young male patients with IBD receiving co-treatment with anti-TNF agents and thiopurines, need to be incorporated into clinical practice in order to decide which treatment will be the most efficient - and also the safest - for each patient.
UR - http://www.scopus.com/inward/record.url?scp=84863823701&partnerID=8YFLogxK
M3 - Review article
AN - SCOPUS:84863823701
SN - 1466-7401
VL - 11
SP - 93
EP - 102
JO - Inflammatory Bowel Disease Monitor
JF - Inflammatory Bowel Disease Monitor
IS - 3
ER -