Risk and clinical characteristics of lymphoma in Korean patients with inflammatory bowel diseases: a multicenter study.
OBJECTIVE
Studies of lymphoma risk in Western inflammatory bowel disease (IBD) patients show conflicting results; however, none have examined the lymphoma risk and clinical characteristics of Asian IBD patients.


METHODS
Patients with lymphoma were identified in an IBD database from 3 tertiary referral centers in Seoul, Korea. The standardized incidence ratio (SIR) of lymphoma was estimated using data from the Korea Central Cancer Registry of the National Cancer Center. The risk of lymphoma in relation to specific medications was also explored.


RESULTS
Seven cases of lymphoma (0.1%) were identified in 6585 IBD patients. The median age at lymphoma diagnosis was 43 years (range, 33 to 70 y) and the median duration of IBD at lymphoma diagnosis was 96.1 months (range, 15.1 to 171.6 mo). Three patients had underlying ulcerative colitis and 4 had Crohn's disease (CD). Non-Hodgkin lymphoma was diagnosed in 5 patients (71.4%) and Hodgkin disease (HD) in 2 patients (28.6%). The SIR of lymphoma was 2.03 [95% confidence interval (CI), 0.81-4.18] in the entire IBD patients. Both the SIR of lymphoma in CD patients (9.31; 95% CI, 1.13-33.62) and the SIR of HD (13.16; 95% CI, 1.59-47.53) in IBD patients were increased. The SIR of lymphoma in patients who were exposed to thiopurines was 5.93 (95% CI, 1.61-15.18).


CONCLUSIONS
The risk of lymphoma in CD patients and the risk of HD in IBD patients seem to be increased in Korea. Thiopurine may be related with the risk of lymphoma in Korean IBD patients.
Departments of *Gastroenterology †Inflammatory Bowel Disease Center ∥Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine ‡Department of Internal Medicine, Division of Gastroenterology, Seoul National University College of Medicine §Department of Medicine, Division of Gastroenterology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Soo-Kyung
SK
Park
Byong Duk
BD
Ye
Changhyun
C
Lee
Jong Pil
JP
Im
Young-Ho
YH
Kim
Seon-Ok
SO
Kim
Jeong-Sik
JS
Byeon
Seung-Jae
SJ
Myung
Suk-Kyun
SK
Yang
Jin-Ho
JH
Kim
D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000009:adverse effects; D044466:Asian People; D003093:Colitis, Ulcerative / Q000175:diagnosis / Q000188:drug therapy / Q000208:ethnology*; D003424:Crohn Disease / Q000175:diagnosis / Q000188:drug therapy / Q000208:ethnology*; D016208:Databases, Factual; D005260:Female; D005765:Gastrointestinal Agents / Q000009:adverse effects; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008223:Lymphoma / Q000139:chemically induced / Q000175:diagnosis / Q000208:ethnology*; D008297:Male; D008875:Middle Aged; D012042:Registries; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D062606:Tertiary Care Centers; D013997:Time Factors
D000893:Anti-Inflammatory Agents; D005765:Gastrointestinal Agents