Korean J Gastroenterol.  2011 Oct;58(4):171-177. 10.4166/kjg.2011.58.4.171.

Inflammatory Bowel Disease and Lymphoproliferative Disorders

• Ye BD

• KMID: 1718424
• DOI: http://doi.org/10.4166/kjg.2011.58.4.171

Abstract

The risk of lymphoproliferative disorders (LPDs) has been reported to be increased in autoimmune diseases and chronic inflammatory diseases. Similar with other chronic inflammatory diseases such as rheumatoid arthritis, there is a concern about the risk of LPDs in patients with inflammatory bowel disease (IBD). Generally, in IBD patients, the risk of LPDs appears to be similar with or very slightly higher, compared to the general population. The association of therapeutic agents with the risk of LPDs is difficult to evaluate due to multiple other potentially involved factors and co-treatment with other agents. To date, data show that thiopurine is associated with a moderately increased risk of LPDs in patients with IBD. Evidence regarding the risk of LPDs in IBD patients using methotrexate is not sufficient, but the risk of LPDs seems low. The responsibility of anti-TNF-alpha agents on the risk of LPDs is difficult to determine, because most of IBD patients receiving anti-TNF-alpha agents are co-treated with thiopurines. Attention should be given to the high risk of hepatosplenic T-cell lymphoma in young male patients treated with anti-TNF-alpha agents together with thiopurines. The risk and benefit of immunosuppressive therapy for IBD should be carefully evaluated and individualized considering the risk of LPDs.

Keyword

Inflammatory bowel diseases; Lymphoproliferative disorders; Azathioprine; 6-Mercaptopurine; Tumor necrosis factor-alpha

MeSH Terms

Anti-Inflammatory Agents/therapeutic use
Antibodies, Monoclonal/therapeutic use
Azathioprine/adverse effects/therapeutic use
Humans
Immunosuppressive Agents/adverse effects/therapeutic use
Inflammatory Bowel Diseases/complications/*drug therapy
Lymphoproliferative Disorders/chemically induced/*etiology
Methotrexate/therapeutic use
Risk Factors