Update on the risk of lymphoma following immunosuppressive therapy for inflammatory bowel disease

Abstract

The care of inflammatory bowel disease has changed considerably with the introduction of a number of immunosuppressants including anti-metabolite and anti-TNF therapies. While efficacious, these medications also carry important risks, notably the potential risk of lymphoma. This risk is one of the most worrisome for both patients and physicians. Our current knowledge is still evolving; however, our understanding of what risks these drugs carry, both individually and synergistically, is critical in allowing informed decision making. In this article, we will describe the known lymphoma risks of commonly used immunosuppressant medications in inflammatory bowel disease, with an emphasis on non-Hodgkin’s lymphoma and hepatosplenic T-cell lymphoma.

Keywords::

• hepatosplenic T-cell lymphoma
• immunosuppression
• inflammatory bowel disease
• lymphoma
• non-Hodgkin’s lymphoma

Financial & competing interests disclosure

This work was supported in part by NIH grants K08 DK084347 (Meenakshi Bewtra) and K24-DK078228 (James D Lewis). Meenakshi Bewtra reports having received research funding from Centocor. James D Lewis reports having received research funding from Centocor, Takeda and Shire. James D Lewis has served as a paid consultant for Millennium Pharmaceuticals, AstraZeneca, GlaxoSmithKline and Amgen. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.