The relationship between infliximab treatment and lymphoma in Crohn's disease

Bickston, Stephen J.; Lichtenstein, Gary R.; Arseneau, Kristen O.; Cohen, Roger B.; Cominelli, Fabio

doi:10.1016/s0016-5085(99)70294-5

Cited by 194 publications

(106 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…A recent and extensive meta-analysis has also recently confirmed the increased colorectal and small bowel cancer risk in Crohn's disease [12] . Moreover, other malignancies have been reported in Crohn's disease, including myeloid and lymphoid malignancies [13] , possibly related, in part, to wider use of immunosuppressants or biological agents (e.g., infliximab) [14,15] . …”

Section: Crohn's Disease and Cancer Riskmentioning

confidence: 99%

Colorectal cancer risk in Crohn’s disease

Freeman¹

2008

WJG

View full text Add to dashboard Cite

Section: Crohn's Disease and Cancer Riskmentioning

confidence: 99%

Colorectal cancer risk in Crohn’s disease

Freeman¹

2008

WJG

View full text Add to dashboard Cite

“…The same problem, i.e., an inability to distinguish therapy-related effects from effects of the disease, is encountered in case-control studies whose results have indicated increased lymphoma risks after treatment with nonsteroidal antiinflammatory drugs (NSAIDs) and aspirin (18,19) and with corticosteroids (20,21). Reports based on case series and comparisons with age-matched healthy population controls have also linked tumor necrosis factor (TNF) blockade treatment to increased lymphoma risk (8,(22)(23)(24). Importantly, though, none of the above studies has been able to pinpoint the specific effects of disease activity on lymphoma risk, let alone distinguish them from the effects of treatment.…”

mentioning

confidence: 99%

Association of chronic inflammation, not its treatment, with increased lymphoma risk in rheumatoid arthritis

Baecklund

Iliadou

Askling

et al. 2006

Arthritis & Rheumatism

790

562

View full text Add to dashboard Cite

Objective. Chronic inflammatory conditions such as rheumatoid arthritis (RA) have been associated with malignant lymphomas. This study was undertaken to investigate which patients are at highest risk, and whether antirheumatic treatment is hazardous or protective.Methods. We performed a matched case-control study of 378 consecutive Swedish RA patients in whom malignant lymphoma occurred between 1964 and 1995 (from a population-based RA cohort of 74,651 RA patients), and 378 controls. Information on disease characteristics and treatment from onset of RA until lymphoma diagnosis was abstracted from medical records. Lymphoma specimens were reclassified and tested for Epstein-Barr virus (EBV). Relative risks (odds ratios [ORs]) for lymphomas (by subtype) associated with deciles of cumulative disease activity were assessed, as were ORs associated with drug treatments.Results. The relative risks of lymphoma were only modestly elevated up to the seventh decile of cumulative disease activity. Thereafter, the relative risk increased Conclusion. Risk of lymphoma is substantially increased in a subset of patients with RA, those with very severe disease. High inflammatory activity, rather than its treatment, is a major risk determinant.

show abstract

“…In light of the recent introduction of potent therapy with tumor necrosis factor ␣ (TNF␣) inhibitors in RA and other inflammatory conditions (a treatment with which development of malignant lymphomas remains a concern [21,22]), it has become increasingly important to determine how the 2 disease groups interact. Thus, we need not only to obtain a better assessment of the "expected" risk of malignant lymphoma in patients with RA (before the introduction of TNF␣ inhibitor therapy), but also to try to separate potential risk factors (genetic or environmental) common to RA and malignant lymphomas from lymphomagenic factors related to the rheumatic disease itself or its treatment.…”

mentioning

confidence: 99%

Risk of malignant lymphomas in patients with rheumatoid arthritis and in their first‐degree relatives

Ekström¹,

Hjalgrim²,

Brandt³

et al. 2003

Arthritis & Rheumatism

250

152

View full text Add to dashboard Cite

Objective. Patients with rheumatoid arthritis (RA) are at increased risk for malignant lymphomas. Both conditions display a familial aggregation, and there are reports of RA and malignant lymphomas occurring in the same families. This study was undertaken to determine the risk of malignant lymphomas in first-degree relatives of RA patients, in order to investigate whether the increased risk of malignant lymphomas in RA could be due to genetic or environmental risk factors common to both conditions, rather than being a consequence of the rheumatic disease.Methods. Using Swedish nationwide and population-based registers, we identified 76,527 patients hospitalized with RA in 1964-1999 and 70,290 firstdegree relatives of a subset of these patients. These subjects were followed up for more than 3 decades, and information on cancer occurrence was recorded.Results. Patients with RA had a significantly increased risk of malignant lymphomas (535 cases; standardized incidence ratio [SIR] 2.00, 95% confidence interval [95% CI] 1.83-2.17), which was apparent for up to 2 decades of followup. Among the first-degree relatives without RA, no increased risk of malignant lymphomas was found overall, although modest and nonsignificantly elevated risk estimates were observed in subgroups. With respect to childhood cancer (0-14 years of age), we observed an increased risk of Hodgkin's lymphoma (5 cases; SIR 3.18, 95% CI 1.03-7.42).Conclusion. Patients with RA are at a markedly, but possibly time-limited, increased risk for malignant lymphomas. There is little to suggest a prominent role for coinherited or common environmental risk factors in malignant lymphomas arising in the context of RA. Instead, lymphomas complicating RA appear to be a direct consequence of the inflammation or its treatment.

show abstract

The relationship between infliximab treatment and lymphoma in Crohn's disease

Cited by 194 publications

References 33 publications

Colorectal cancer risk in Crohn’s disease

Colorectal cancer risk in Crohn’s disease

Association of chronic inflammation, not its treatment, with increased lymphoma risk in rheumatoid arthritis

Risk of malignant lymphomas in patients with rheumatoid arthritis and in their first‐degree relatives

Contact Info

Product

Resources

About