Guerra Ivan, Bujanda Luis, Mañosa Miriam, Pérez-Martínez Isabel, Casanova María José, de la Peña Luisa, de Benito Marina, Rivero Montserrat, Varela Pilar, Bernal Lorena, Franco Ana Carolina, Ber Yolanda, Piqueras Marta, Tardillo Carlos, Ponferrada Ángel, Olivares Sonsoles, Lucendo Alfredo J, Gilabert Pau, Sierra Ausín Mónica, Bellart María, Herrarte Amaia, Calafat Margalida, de Francisco Ruth, Gisbert Javier P, Guardiola Jordi, Domènech Eugeni, Bermejo Fernando
Gastroenterology Unit, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain.
Gastroenterology Unit, Hospital Donostia/Instituto Biodonostia, Universidad del País Vasco UPV/EHU, 20014 Donostia-San Sebastián, Spain.
Cancers (Basel). 2023 Jan 25;15(3):750. doi: 10.3390/cancers15030750.
An increased risk of lymphoma has been described in patients with inflammatory bowel disease (IBD). The aims of our study were to determine the clinical presentation, the previous exposure to immunosuppressive and biologic therapies, and the evolution of lymphomas in patients with IBD. IBD patients with diagnosis of lymphoma from October 2006 to June 2021 were identified from the prospectively maintained ENEIDA registry of GETECCU. We identified 52 patients (2.4 cases of lymphoma/1000 patients with IBD; 95% CI 1.8-3.1). Thirty-five were men (67%), 52% had ulcerative colitis, 60% received thiopurines, and 38% an anti-TNF drug before lymphoma diagnosis. Age at lymphoma was lower in those patients treated with thiopurines (53 ± 17 years old) and anti-TNF drugs (47 ± 17) than in those patients not treated with these drugs (63 ± 12; < 0.05). Five cases had relapse of lymphoma (1.7 cases/100 patient-years). Nine patients (17%) died after 19 months (IQR 0-48 months). Relapse and mortality were not related with the type of IBD or lymphoma, nor with thiopurines or biologic therapies. In conclusion, most IBD patients had been treated with thiopurines and/or anti-TNF agents before lymphoma diagnosis, and these patients were younger at diagnosis of lymphoma than those not treated with these drugs. Relapse and mortality of lymphoma were not related with these therapies.
炎症性肠病（IBD）患者患淋巴瘤的风险增加。我们研究的目的是确定IBD患者淋巴瘤的临床表现、既往免疫抑制和生物治疗暴露情况以及淋巴瘤的演变。从GETECCU前瞻性维护的ENEIDA登记处识别出2006年10月至2021年6月诊断为淋巴瘤的IBD患者。我们确定了52例患者（每1000例IBD患者中有2.4例淋巴瘤；95%可信区间1.8 - 3.1）。35例为男性（67%），52%患有溃疡性结肠炎，60%在淋巴瘤诊断前接受硫唑嘌呤治疗，38%接受抗TNF药物治疗。接受硫唑嘌呤治疗的患者（53±17岁）和抗TNF药物治疗的患者（47±17岁）淋巴瘤发病年龄低于未接受这些药物治疗的患者（63±12岁；P<0.05）。5例患者淋巴瘤复发（1.7例/100患者年）。9例患者（17%）在19个月后死亡（四分位间距0 - 48个月）。复发和死亡率与IBD或淋巴瘤类型无关，也与硫唑嘌呤或生物治疗无关。总之，大多数IBD患者在淋巴瘤诊断前接受过硫唑嘌呤和/或抗TNF药物治疗，这些患者淋巴瘤诊断时的年龄比未接受这些药物治疗的患者年轻。淋巴瘤的复发和死亡率与这些治疗无关。
