title: Clinical course of Crohn's disease following treatment of lymphoma.
abstract: BACKGROUND
  Crohn's disease (CD) patients may be at increased risk for the development of Hodgkin's lymphoma (HL) or non-Hodgkin's lymphoma (NHL), either through exposure to immunosuppressive medications or due to their underlying chronic inflammatory illness. There are limited data regarding the natural history of CD following treatment of lymphoma. We present a series of CD patients who were treated for lymphoma and describe the natural history of their CD following lymphoma treatment.
  
  
  METHODS
  Retrospective case series from three academic referral centers was used. All CD patients with a history of lymphoma were identified. Demographic data, CD medication exposure, and surgical procedures before and after lymphoma treatment were recorded.
  
  
  RESULTS
  Nine CD patients with a history of lymphoma were identified. Eight individuals received chemotherapy, while one patient was observed without treatment. Eight patients remained free of lymphoma for a mean of 72.8 months (range 1-276 months). The ninth patient had recurrence of his HL 3 years after lymphoma diagnosis. Following lymphoma treatment, two patients had quiescent CD with no specific therapy. Three patients demonstrated significant clinical relapse of their CD and a fourth patient developed CD after treatment of her lymphoma, which ultimately required long-term immunomodulator therapy with 6-mercaptopurine or methotrexate in the first three patients, and azathioprine in the fourth. Four patients required CD surgery after lymphoma treatment.
  
  
  CONCLUSIONS
  We report on the clinical course of CD in patients who develop lymphoma. Significant clinical relapse of CD following successful medical treatment of lymphoma occurred frequently in patients with a history of this neoplasm.
authors.affiliation: Division of Gastroenterology, Hepatology, and Nutrition, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
authors.forename: Marwa
authors.initials: M
authors.lastname: El Mourabet
authors.forename: Jana G
authors.initials: JG
authors.lastname: Hashash
authors.forename: Nicholas H
authors.initials: NH
authors.lastname: Sun
authors.forename: Mazen
authors.initials: M
authors.lastname: Issa
authors.forename: Jeffry A
authors.initials: JA
authors.lastname: Katz
authors.forename: Miguel
authors.initials: M
authors.lastname: Regueiro
authors.forename: Arthur M
authors.initials: AM
authors.lastname: Barrie
authors.forename: Leonard
authors.initials: L
authors.lastname: Baidoo
authors.forename: Marc B
authors.initials: MB
authors.lastname: Schwartz
authors.forename: Jason M
authors.initials: JM
authors.lastname: Swoger
authors.forename: Marc C
authors.initials: MC
authors.lastname: Levesque
authors.forename: David G
authors.initials: DG
authors.lastname: Binion
mesh_terms: D000293:Adolescent; D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use; D002648:Child; D003424:Crohn Disease / Q000150:complications* / Q000188:drug therapy; D005260:Female; D006689:Hodgkin Disease / Q000150:complications / Q000188:drug therapy; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use; D008223:Lymphoma / Q000150:complications* / Q000188:drug therapy; D008228:Lymphoma, Non-Hodgkin / Q000150:complications / Q000188:drug therapy; D008297:Male; D015122:Mercaptopurine / Q000009:adverse effects / Q000627:therapeutic use; D008727:Methotrexate / Q000009:adverse effects / Q000627:therapeutic use; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents; D007166:Immunosuppressive Agents; D015122:Mercaptopurine; D008727:Methotrexate