Risk factors for lymphoma in patients with inflammatory bowel disease: A case-control study

Waqqas Afif, William J. Sandborn, William Alvis Faubion, Meher Rahman, Scott W. Harmsen, Alan R. Zinsmeister, Edward Vincent Loftus, Jr

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Background: Subgroups of patients with inflammatory bowel disease (IBD) may have an increased risk of developing lymphoma. We sought to identify factors that were associated with lymphoma in patients with IBD. Methods: Cases and controls were identified through a centralized diagnostic index. We identified 80 adult patients with IBD who developed lymphoma between 1980 and 2009. For each case, 2 controls were matched for subtype of IBD, geographic location, and length of follow-up. Conditional logistical regression was used to assess associations between risk factors and the development of lymphoma. Results: Sixty patients were males (75%) versus 77 controls (48%). Median age at index date was 59 years for cases and 42 years for controls. Twenty patients (25%) and 23 controls (14%) were receiving immunosuppressive medications at the index date. Four patients (5%) and 6 controls (4%) were receiving anti-tumor necrosis factor α agents at the index date. In multiple variable analysis, age per decade (odds ratio, 1.83;95% confidence interval, 1.37-2.43), male gender (odds ratio, 4.05;95% confidence interval, 1.82-9.02) and immunosuppressive exposure at the index date (odds ratio, 4.20;95% confidence interval, 1.35-13.11) were significantly associated with increased odds of developing lymphoma. Disease severity and use of anti-tumor necrosis factor α agents were not independently associated with developing lymphoma. When testing was performed on patients exposed to immunosuppressive or anti-tumor necrosis factor α medications, Epstein-Barr virus was identified 75% of the time. Conclusions: In this case-control study, increasing age, male gender, and use of immunosuppressive medications were associated with an increased risk of lymphoma in patients with IBD.

Original languageEnglish (US)
Pages (from-to)1384-1389
Number of pages6
JournalInflammatory Bowel Diseases
Volume19
Issue number7
DOIs
StatePublished - Jun 2013

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Inflammatory Bowel Diseases
Case-Control Studies
Lymphoma
Immunosuppressive Agents
Tumor Necrosis Factor-alpha
Odds Ratio
Confidence Intervals
Geographic Locations
Human Herpesvirus 4

Keywords

  • Anti-TNF-α
  • Immunosuppressive
  • Lymphoma

ASJC Scopus subject areas

  • Gastroenterology
  • Immunology and Allergy

Cite this

Risk factors for lymphoma in patients with inflammatory bowel disease : A case-control study. / Afif, Waqqas; Sandborn, William J.; Faubion, William Alvis; Rahman, Meher; Harmsen, Scott W.; Zinsmeister, Alan R.; Loftus, Jr, Edward Vincent.

In: Inflammatory Bowel Diseases, Vol. 19, No. 7, 06.2013, p. 1384-1389.

Research output: Contribution to journalArticle

Afif, Waqqas ; Sandborn, William J. ; Faubion, William Alvis ; Rahman, Meher ; Harmsen, Scott W. ; Zinsmeister, Alan R. ; Loftus, Jr, Edward Vincent. / Risk factors for lymphoma in patients with inflammatory bowel disease : A case-control study. In: Inflammatory Bowel Diseases. 2013 ; Vol. 19, No. 7. pp. 1384-1389.
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abstract = "Background: Subgroups of patients with inflammatory bowel disease (IBD) may have an increased risk of developing lymphoma. We sought to identify factors that were associated with lymphoma in patients with IBD. Methods: Cases and controls were identified through a centralized diagnostic index. We identified 80 adult patients with IBD who developed lymphoma between 1980 and 2009. For each case, 2 controls were matched for subtype of IBD, geographic location, and length of follow-up. Conditional logistical regression was used to assess associations between risk factors and the development of lymphoma. Results: Sixty patients were males (75{\%}) versus 77 controls (48{\%}). Median age at index date was 59 years for cases and 42 years for controls. Twenty patients (25{\%}) and 23 controls (14{\%}) were receiving immunosuppressive medications at the index date. Four patients (5{\%}) and 6 controls (4{\%}) were receiving anti-tumor necrosis factor α agents at the index date. In multiple variable analysis, age per decade (odds ratio, 1.83;95{\%} confidence interval, 1.37-2.43), male gender (odds ratio, 4.05;95{\%} confidence interval, 1.82-9.02) and immunosuppressive exposure at the index date (odds ratio, 4.20;95{\%} confidence interval, 1.35-13.11) were significantly associated with increased odds of developing lymphoma. Disease severity and use of anti-tumor necrosis factor α agents were not independently associated with developing lymphoma. When testing was performed on patients exposed to immunosuppressive or anti-tumor necrosis factor α medications, Epstein-Barr virus was identified 75{\%} of the time. Conclusions: In this case-control study, increasing age, male gender, and use of immunosuppressive medications were associated with an increased risk of lymphoma in patients with IBD.",
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T2 - A case-control study

AU - Afif, Waqqas

AU - Sandborn, William J.

AU - Faubion, William Alvis

AU - Rahman, Meher

AU - Harmsen, Scott W.

AU - Zinsmeister, Alan R.

AU - Loftus, Jr, Edward Vincent

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N2 - Background: Subgroups of patients with inflammatory bowel disease (IBD) may have an increased risk of developing lymphoma. We sought to identify factors that were associated with lymphoma in patients with IBD. Methods: Cases and controls were identified through a centralized diagnostic index. We identified 80 adult patients with IBD who developed lymphoma between 1980 and 2009. For each case, 2 controls were matched for subtype of IBD, geographic location, and length of follow-up. Conditional logistical regression was used to assess associations between risk factors and the development of lymphoma. Results: Sixty patients were males (75%) versus 77 controls (48%). Median age at index date was 59 years for cases and 42 years for controls. Twenty patients (25%) and 23 controls (14%) were receiving immunosuppressive medications at the index date. Four patients (5%) and 6 controls (4%) were receiving anti-tumor necrosis factor α agents at the index date. In multiple variable analysis, age per decade (odds ratio, 1.83;95% confidence interval, 1.37-2.43), male gender (odds ratio, 4.05;95% confidence interval, 1.82-9.02) and immunosuppressive exposure at the index date (odds ratio, 4.20;95% confidence interval, 1.35-13.11) were significantly associated with increased odds of developing lymphoma. Disease severity and use of anti-tumor necrosis factor α agents were not independently associated with developing lymphoma. When testing was performed on patients exposed to immunosuppressive or anti-tumor necrosis factor α medications, Epstein-Barr virus was identified 75% of the time. Conclusions: In this case-control study, increasing age, male gender, and use of immunosuppressive medications were associated with an increased risk of lymphoma in patients with IBD.

AB - Background: Subgroups of patients with inflammatory bowel disease (IBD) may have an increased risk of developing lymphoma. We sought to identify factors that were associated with lymphoma in patients with IBD. Methods: Cases and controls were identified through a centralized diagnostic index. We identified 80 adult patients with IBD who developed lymphoma between 1980 and 2009. For each case, 2 controls were matched for subtype of IBD, geographic location, and length of follow-up. Conditional logistical regression was used to assess associations between risk factors and the development of lymphoma. Results: Sixty patients were males (75%) versus 77 controls (48%). Median age at index date was 59 years for cases and 42 years for controls. Twenty patients (25%) and 23 controls (14%) were receiving immunosuppressive medications at the index date. Four patients (5%) and 6 controls (4%) were receiving anti-tumor necrosis factor α agents at the index date. In multiple variable analysis, age per decade (odds ratio, 1.83;95% confidence interval, 1.37-2.43), male gender (odds ratio, 4.05;95% confidence interval, 1.82-9.02) and immunosuppressive exposure at the index date (odds ratio, 4.20;95% confidence interval, 1.35-13.11) were significantly associated with increased odds of developing lymphoma. Disease severity and use of anti-tumor necrosis factor α agents were not independently associated with developing lymphoma. When testing was performed on patients exposed to immunosuppressive or anti-tumor necrosis factor α medications, Epstein-Barr virus was identified 75% of the time. Conclusions: In this case-control study, increasing age, male gender, and use of immunosuppressive medications were associated with an increased risk of lymphoma in patients with IBD.

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