Hepatosplenic T-Cell Lymphoma in an Adolescent Patient after Immunomodulator and Biologic Therapy for Crohn Disease

Thayu, Meena; Markowitz, Jonathan E.; Mamula, Petar; Russo, Pierre; Muinos, William; Baldassano, Robert N.

doi:10.1097/00005176-200502000-00026

Cited by 137 publications

(78 citation statements)

References 19 publications

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“…Nella nostra esperienza abbiamo osservato un caso di micro-carcinoma tiroideo in una giovane trattata con Etanercept e precedentemente anche con Infliximab e numerosi altri DMARDs (93). Recentemente, sono stati descritti alcuni casi di linfomi epato-splenici T-linfocitari in adolescenti trattati con Infliximab per il morbo di Crohn (150).…”

Section: Eventi Avversi Dell'inibizione Del Tnfunclassified

Biological therapy with TNF-inhibitors in pediatric rheumatology. Review of the litterature and personal experience

Gerloni¹,

Pontikaki²,

Gattinara³

et al. 2011

Reumatismo

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The therapeutic approach to JIA is sometimes very troublesome and progression to erosive polyarthritis may occur in all JIA categories. Only Methotrexate has shown efficacy and safety in a large controlled trial. Nevertheless, in many cases, drug resistance or intolerance has led to try other therapeutic options, with still debatable results. Therefore, there has been space, in the last few years, for new therapies as the TNF-inhibitors. This therapeutic approach has shown a dramatic clinical benefit in active polyarticular refractory JIA: the rate and rapidity of response have exceeded those of all other studied DMARDs. Preliminary data show that they are efficacious also for other pediatric rheumatic disease (spondyloarthropathies, autoimmune uveitis, dermatomyositis, Kawasaki syndrome and some auto- inflammatory diseases). TNF-inhibitors in JIA have demonstrated a favourable benefit-to-risk profile. However, as their use has increased worldwide, some unusual, usually not serious, adverse events have emerged. Severe infections, including TB, and deaths have been reported. Long-lasting active disease, systemic disease, concurrent and previous immunosuppressive therapies, all contribute to risk of infection and other serious AEs. Given the evidence that TNF has a primary role in the pathogenesis of JIA, particularly in joint destruction, neutralizing this cytokine early, within the window of opportunity, could halt or delay progression of joint damage and debilitating consequences of the disease. Thus, for JIA patients whose disease is not quickly controlled with MTX, TNF blockers may be considered as first-line treatment, although long-term safety data still need to be established

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Section: Eventi Avversi Dell'inibizione Del Tnfunclassified

Biological therapy with TNF-inhibitors in pediatric rheumatology. Review of the litterature and personal experience

Gerloni¹,

Pontikaki²,

Gattinara³

et al. 2011

Reumatismo

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“…In 2008, the FDA extended its investigation to include cancer risk in children and young adults after it was reported that 10 cases of a rare gastrointestinal lymphoma occurred in pediatric patients with CD treated with anti-TNF agents (15,16). In all, the FDA identified 48 children and young adults who developed cancer between 2001 and 2008 while being treated with anti-TNF therapy of a total of 26,673 treated, for an age-adjusted incidence rate of 25.7 per 100,000 (17) as compared with the reported rate of 16.6 per 100,000 for all US children (17,18).…”

Section: Anti-tnf Therapy and Cancermentioning

confidence: 99%

Anti–tumor necrosis factor therapy and cancer risk in patients with autoimmune disorders

Onel¹,

Onel²

2010

Arthritis Care & Research

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“…Moreover, the increasing concern of hepatic T-cell lymphoma has led many physicians to consider discontinuing either 6-MP or AZA with the introduction of biological therapy. 27 Although all anti-TNFα therapies have antigenic properties, those patients on infliximab therapy are most vulnerable. The concurrent use of immunosuppressive therapy has in the past been shown by Rutgeerts and coworkers to maintain a favorable clinical response to maintenance infliximab therapy, presumably due to the prevention of human anti-chimeric antibody (HACA) antibody formation.…”

Section: Infliximabmentioning

confidence: 99%

Infliximab therapy in pediatric Crohn’s disease: a review

Parashette

Makam

Cuffari

2010

CEG

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Anti-tumor necrosis factor alpha (TNF-α) therapy has re-defined our treatment paradigms in managing patients with Crohn's disease (CD) and ulcerative colitis. Although the ACCENT studies showed proven efficacy in the induction and maintenance of disease remission in adult patients with moderate to severe CD, the pediatric experience was instrumental in bringing forth the notion of "top-down" therapy to improve overall clinical response while reducing the risk of complications resulting from long-standing active disease. Infliximab has proven efficacy in the induction and maintenance of disease remission in children and adolescents with CD. In an open-labeled study of 112 pediatric patients with moderate to severe CD, 58% achieved clinical remission on induction of infliximab (5 mg/kg) therapy. Among those patients who achieved disease remission, 56% maintained disease remission on maintenance (5 mg/kg every 8 weeks) therapy. Longitudinal follow-up studies have also shown that responsiveness to infliximab therapy also correlates well with reduced rates of hospitalization, and surgery for complication of long-standing active disease, including stricture and fistulae formation. Moreover, these children have also been shown to improve overall growth while maintaining an effective disease remission. The pediatric experience has been instructive in suggesting that the early introduction of anti-TNF-α therapy may perhaps alter the natural history of CD in children, an observation that has stimulated a great deal of interest among gastroenterologists who care for adult patients with CD.

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Hepatosplenic T-Cell Lymphoma in an Adolescent Patient after Immunomodulator and Biologic Therapy for Crohn Disease

Cited by 137 publications

References 19 publications

Biological therapy with TNF-inhibitors in pediatric rheumatology. Review of the litterature and personal experience

Biological therapy with TNF-inhibitors in pediatric rheumatology. Review of the litterature and personal experience

Anti–tumor necrosis factor therapy and cancer risk in patients with autoimmune disorders

Infliximab therapy in pediatric Crohn’s disease: a review

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Hepatosplenic T-Cell Lymphoma in an Adolescent Patient after Immunomodulator and Biologic Therapy for Crohn Disease

Cited by 137 publications

References 19 publications

Biological therapy with TNF-inhibitors in pediatric rheumatology. Review of the litterature and personal experience

Biological therapy with TNF-inhibitors in pediatric rheumatology. Review of the litterature and personal experience

Anti–tumor necrosis factor therapy and cancer risk in patients with autoimmune disorders

Infliximab therapy in pediatric Crohn&rsquo;s disease: a review

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Infliximab therapy in pediatric Crohn’s disease: a review