title: The risk of lymphoma and immunomodulators in patients with inflammatory bowel diseases: results from a population-based cohort in Eastern Europe.
abstract: OBJECTIVE
  Prior studies suggest a small but significantly increased risk of lymphoma in adults with inflammatory bowel disease (IBD), especially in patients treated with thiopurines. No data was available from Eastern Europe. The aim of this study was to analyze the incidence of lymphomas as related to drug exposure, in a population-based Veszprem province database, which included incident cases diagnosed between January 1, 1977 and December 31, 2008.
  
  
  METHODS
  Data from 1420 incident patients were analyzed (UC: 914, age at diagnosis: 36.5 years; CD: 506, age at diagnosis: 28.5.5 years). Both in- and outpatient records were collected and comprehensively reviewed. The rate of lymphoma was calculated as patient-years of exposure per medication class, of medications utilized in IBD.
  
  
  RESULTS
  Of the 1420 patients, we identified three patients who developed lymphoma (one CLL, two low-grade B-cell NHL including one rectal case), during 19,293 patient-years of follow-up (median follow-up: 13 years). All three patients were male. None had received azathioprine or biologicals. The absolute incidence rate of lymphoma was 1.55 per 10,000 patient-years, with 3 cases observed vs. 2.18 expected, with a standardized incidence ratio (SIR) of 1.37 (95% confidence interval [CI]: 0.44-4.26). No cases have been exposed to either azathioprine or biologicals.
  
  
  CONCLUSIONS
  The overall risk of lymphoma in IBD was not increased; only three cases were seen in this population-based incident cohort over a 30-year period. An association with thiopurine exposure was not found.
authors: 1st Department of Medicine, Semmelweis University, Budapest, Hungary. lakatos.peter_laszlo@med.semmelweis-univ.hu
authors: Peter L
authors: PL
authors: Lakatos
authors: Barbara D
authors: BD
authors: Lovasz
authors: Gyula
authors: G
authors: David
authors: Tunde
authors: T
authors: Pandur
authors: Zsuzsanna
authors: Z
authors: Erdelyi
authors: Gabor
authors: G
authors: Mester
authors: Mihaly
authors: M
authors: Balogh
authors: Istvan
authors: I
authors: Szipocs
authors: Csaba
authors: C
authors: Molnar
authors: Erzsebet
authors: E
authors: Komaromi
authors: Petra A
authors: PA
authors: Golovics
authors: Zsuzsanna
authors: Z
authors: Vegh
authors: Michael
authors: M
authors: Mandel
authors: Agnes
authors: A
authors: Horvath
authors: Miklos
authors: M
authors: Szathmari
authors: Lajos S
authors: LS
authors: Kiss
authors: Laszlo
authors: L
authors: Lakatos
mesh_terms: D000328:Adult; D000368:Aged; D000911:Antibodies, Monoclonal / Q000009:adverse effects / Q000627:therapeutic use*; D001379:Azathioprine / Q000009:adverse effects / Q000627:therapeutic use*; D003093:Colitis, Ulcerative / Q000188:drug therapy; D003424:Crohn Disease / Q000188:drug therapy; D005260:Female; D006801:Humans; D006814:Hungary / Q000453:epidemiology; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D015994:Incidence; D000069285:Infliximab; D008228:Lymphoma, Non-Hodgkin / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors; D055815:Young Adult
chemical_list: D000911:Antibodies, Monoclonal; D007166:Immunosuppressive Agents; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab; D001379:Azathioprine