Effect of a gluten-free diet on the risk of enteropathy-associated T-cell lymphoma in celiac disease.
Patients with celiac disease have an increased rate of enteropathy-associated T-cell lymphoma, but conflicting data are available about the protective role of a gluten-free diet with regard to the development of this malignancy. We followed 1,757 celiac patients for a total period of 31,801 person-years, collecting data about the frequency of gluten intake and the incidence of the enteropathy-associated T-cell lymphoma. Out of the nine celiac patients who developed an intestinal lymphoma [standard morbidity ratio of 6.42 (95% CI = 2.9-12.2; P < 0.001)], only two kept a strict gluten-free diet after the diagnosis of celiac disease and developed the malignancy after the peridiagnosis period of 3 years, dropping therefore the standard morbidity ratio to 0.22 (95%CI = 0.02-0.88; P < 0.001). The risk of developing an intestinal lymphoma for the celiac patients that used to have dietary gluten was significant (X(2 )= 4.8 P = 0.01). These results show that a strict gluten-free diet is protective towards the development of enteropathy-associated T-cell lymphoma.
Silano
Marco
M
Division of Food Science, Human Nutrition and Health, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy. marco.silano@iss.it
Volta
Umberto
U
Vincenzi
Alessandro De
AD
Dessì
Mariarita
M
Vincenzi
Massimo De
MD
D000293:Adolescent; D000328:Adult; D002446:Celiac Disease / Q000150:complications* / Q000178:diet therapy*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D005983:Glutens; D006801:Humans; D007223:Infant; D007414:Intestinal Neoplasms / Q000209:etiology / Q000517:prevention & control*; D016399:Lymphoma, T-Cell / Q000209:etiology / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D013274:Stomach Neoplasms / Q000209:etiology / Q000517:prevention & control*; D013997:Time Factors
D005983:Glutens