Stasik Katarzyna, Filip Rafał
Department of Gastroenterology with IBD Unit, Clinical Hospital No. 2, 35-301 Rzeszow, Poland.
Faculty of Medicine, University of Rzeszow, 35-959 Rzeszow, Poland.
Int J Mol Sci. 2024 Apr 11;25(8):4241. doi: 10.3390/ijms25084241.
Patients with inflammatory bowel disease may be at higher risk of developing lymphomas and other cancers of the gastrointestinal tract. In addition, there may be a link between the use of thiopurines or anti-tumor necrosis factor drugs (anti-TNF) and these pathologies. The treatment of patients with Crohn's disease who have previously been diagnosed with lymphoma is a challenge for gastroenterologists. In this report, we examine important clinical issues related to the treatment of patients with inflammatory bowel disease with active lymphoma, as well as of patients with hematological cancer history. In this discussion, we take into account most of the available treatments for inflammatory bowel disease, as well as the impact of chronic inflammation and viral infections. In addition, we try to find common ground for the development of lymphoproliferative disorders and autoimmune diseases. Patients with inflammatory bowel disease may be at higher risk of developing lymphomas and other cancers of the gastrointestinal tract. Chronic inflammatory processes and viral infections play an important role in carcinogenesis. In addition, there may be a link between the use of thiopurines or anti-TNF drugs and these pathologies. A significant risk of the development of lymphoma in people undergoing each therapy should be considered, and it should be estimated how much greater this risk will be in patients with a history of lymphoproliferative disorders. The following review is an attempt to answer which therapy would be the most appropriate for patients with Crohn's disease and a history of lymphoma treatment. A lack of clear guidelines creates great challenges for doctors.
炎症性肠病患者患淋巴瘤和其他胃肠道癌症的风险可能更高。此外,硫唑嘌呤或抗肿瘤坏死因子药物(抗TNF)的使用与这些疾病之间可能存在关联。对于先前已被诊断为淋巴瘤的克罗恩病患者的治疗,是胃肠病学家面临的一项挑战。在本报告中,我们研究了与活动性淋巴瘤的炎症性肠病患者以及有血液系统癌症病史患者的治疗相关的重要临床问题。在本次讨论中,我们考虑了大多数可用的炎症性肠病治疗方法,以及慢性炎症和病毒感染的影响。此外,我们试图找到淋巴增殖性疾病和自身免疫性疾病发展的共同基础。炎症性肠病患者患淋巴瘤和其他胃肠道癌症的风险可能更高。慢性炎症过程和病毒感染在致癌过程中起重要作用。此外,硫唑嘌呤或抗TNF药物的使用与这些疾病之间可能存在关联。应考虑接受每种治疗的人群发生淋巴瘤的重大风险,并应估计有淋巴增殖性疾病病史的患者这种风险会增加多少。以下综述试图回答哪种治疗方法最适合有淋巴瘤治疗史的克罗恩病患者。缺乏明确的指南给医生带来了巨大挑战。