Original article—alimentary tractA Systematic Review of Factors That Contribute to Hepatosplenic T-Cell Lymphoma in Patients With Inflammatory Bowel Disease
Section snippets
Methods
A systematic review of the literature was performed. Databases of literature examined included MEDLINE, EMBASE, the Cochrane Database, Journals@OVID, CAB, and OVID Healthstar. Search terms included a search for the keywords “hepatosplenic” and “lymphoma” with the Boolean operator “AND.” To be included, articles and abstracts required presentation of cases of concurrent IBD and HSTCL. Additional articles were identified in reference lists of selected articles. Non-English articles and abstracts
Results
Thirty-six patients were reported to have developed HSTCL after treatment for IBD since 1996, of whom 20 also were exposed to anti-TNF therapies.1, 2, 3, 4, 9, 11, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27 The range of known patients' ages was 12 to 58 years, with a median age of 22.5 years (Supplementary Table 1).1, 2, 3, 4, 10, 11, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27 Of the 31 patients whose gender was known, 2 (6.5%) were women. With respect to subtype of IBD,
Discussion
Overall, there have been approximately 100 to 200 cases of HSTCL reported in the literature in the past 18 years1, 3, 4, 5; 36 of these cases have occurred in IBD patients exposed to thiopurines. Although reporting bias may play a role, it nonetheless appears likely that patients with IBD are overrepresented in the cases of HSTCL.
From the National Cancer Institute's Surveillance, Epidemiology and End Results database, there were about 157,824 cases of non-Hodgkin's lymphoma from 2001 to 2007;
Acknowledgments
The authors appreciate and acknowledge the assistance of Gerald Falchook, Laurent Beaugerie, and Elizabeth Fowler in providing additional information about their published work.
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Conflicts of interest These authors disclose the following: Gary Lichtenstein has received compensation for research/grant support, support for lectures, and for support for being a member of the scientific advisory committee from the following companies: Centocor, Abbott, UCB, Bristol Meyers-Squibb, Elan, and Prometheus; Robert H. Diamond and Sami Sampat are employees of Centocor Ortho Biotech. The remaining authors disclose no conflicts.