Hepatosplenic T Cell Lymphoma Associated with Infliximab Use in Young Patients Treated for Inflammatory Bowel Disease: Update

Mackey, Ann Corken; Green, Lanh; Leptak, Christopher; Avigan, Mark

doi:10.1097/mpg.0b013e3181957a11

Cited by 97 publications

(51 citation statements)

References 10 publications

(19 reference statements)

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“…Seven cases were associated with azathioprine and three cases with 6-mercaptopurine. No cases have been reported with the use of mesalamine or methotrexate therapy when used to treat IBD [40]. Studies are thus not conclusive for TNF-a inhibitors and HSTCL.…”

Section: Tnf-a Inhibitors and Hstclmentioning

confidence: 97%

Hepatosplenic T-cell lymphoma and TNF-α inhibitors

Pozadzides¹,

Pro

2009

Expert Review of Hematology

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Section: Tnf-a Inhibitors and Hstclmentioning

confidence: 97%

Hepatosplenic T-cell lymphoma and TNF-α inhibitors

Pozadzides¹,

Pro

2009

Expert Review of Hematology

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“…Bereits 2007 beschrieben Mackey et al [18] bei 8 Patienten, dass ein Zusammenhang zwischen der chronischen inflammatorischen Darmerkrankung, dem männlichen Geschlecht, der Therapie mit Infliximab und dem Auftreten eines HSTCL besteht. Seit dem wurden weitere 9 Patienten beschrieben [7,17]. Anzumerken ist dabei, dass alle Patienten mit Azathioprin oder 6-Mercaptopurin vorbehandelt waren -Medikamente die möglicherweise mitentscheidend für das erhöhte Lymphomrisiko sind.…”

Section: Introductionunclassified

Aktualisierte Stellungnahme der GKJR zur Meldung der FDA über Fälle von Malignomen bei Anti-TNF-behandelten Patienten vom 04.08.2009

et al. 2010

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TNF inhibitors and other biologicals have greatly expanded the therapeutic options for juvenile idiopathic arthritis (JIA). While the efficacy of etanercept and adalimumab has been proven in randomized controlled clinical trials, their long-term safety remains the subject of ongoing investigations. Reports of leukaemia and tumours in children and adolescents treated with etanercept, infliximab and adalimumab have raised questions about an increased risk for malignancies, with lymphoma accounting for the largest group at 50% of all 48 malignancies reported by the FDA.Consequently, TNF inhibitors should be indicated under careful consideration of individual risk factors, such as increased family occurrence of malignancies, or pre-treatment with carcinogenic substances such as cyclophosphamide. This is particularly true for non-approved substances, and non-approved indications, and for combination therapy of TNF inhibitors with immunosuppressive drugs. On the other hand, however, treatment should not be stopped or started in any patient in whom treatment is necessary due to the current knowledge. Adequate patient information, surveillance and documentation of treatment in the registry of the GKJR is strongly recommended.

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“…With the reports on hepatosplenic T-cell lymphoma (HSTCL) in predominantly young male patients on combination therapy [17,18], many pediatric gastroenterologists converted to infliximab monotherapy after a short duration of combination therapy. However, according to the SONIC trial [15], the incidence of adverse events (including serious adverse events) and serious infections was similar among the infliximab monotherapy, infliximab plus azathioprine combination therapy and azathioprine monotherapy groups.…”

Section: Safety Of Infliximab In CDmentioning

confidence: 99%