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2 results on '"Bakkal, N."'

1. Risk of malignant lymphoma in patients with inflammatory bowel diseases: a Dutch nationwide study.

Author

Vos AC, Bakkal N, Minnee RC, Casparie MK, de Jong DJ, Dijkstra G, Stokkers P, van Bodegraven AA, Pierik M, van der Woude CJ, Oldenburg B, and Hommes DW

Subjects
Adolescent, Adult, Aged, Aged, 80 and over, Case-Control Studies, Child, Child, Preschool, Cohort Studies, Epstein-Barr Virus Infections complications, Epstein-Barr Virus Infections virology, Female, Follow-Up Studies, Herpesvirus 4, Human pathogenicity, Humans, Incidence, Infant, Infant, Newborn, Inflammatory Bowel Diseases complications, Inflammatory Bowel Diseases epidemiology, Lymphoma epidemiology, Lymphoma virology, Male, Middle Aged, Netherlands epidemiology, Prognosis, Risk Factors, Survival Rate, Young Adult, Azathioprine adverse effects, Immunosuppressive Agents adverse effects, Inflammatory Bowel Diseases drug therapy, Lymphoma chemically induced, Mercaptopurine adverse effects
Abstract

Background: Immune suppressant medications such as thiopurines and anti-tumor necrosis factor agents are important for maintaining disease control in most patients with inflammatory bowel diseases (IBDs); however, their use has been associated with the development of malignant lymphoma. The purpose of this Dutch nationwide study was to estimate the relative risk of malignant lymphoma in IBD patients., Methods: IBD patients who developed a lymphoma between 1997 and 2004 were identified using the Dutch National Database of PALGA. Data from confirmed cases were collected from individual hospitals, including data on Epstein-Barr virus (EBV). The age-adjusted 8-year incidence of malignant lymphoma in the Netherlands was retrieved from the Central Bureau of Statistics., Results: Forty-two hospitals were visited and 285 matches evaluated in the total cohort of 17,834 IBD patients. Forty-four lymphomas were observed, resulting in a relative risk of 1.27 (95% confidence interval [CI]: 0.92-1.68). Only 19 of 44 patients (43%) were exposed to azathioprine/6-mercaptopurine (AZA/6-MP). Remarkably, 92% of patients (11/12) with EBV-positive lymphoma used AZA/6-MP, in contrast to only 19% patients (4/21) with EBV-negative lymphoma, suggesting a strong relation between EBV-positive lymphoma and thiopurine use., Conclusions: This nationwide study does not suggest a significant overall increased risk for lymphoma in IBD patients. A distinct correlation between EBV-positive lymphoma and AZA/6-MP use was observed., (Copyright © 2010 Crohn's & Colitis Foundation of America, Inc.)

Published
2011
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2. Risk of Malignant Lymphoma in Patients with Inflammatory Bowel Diseases: A Dutch Nationwide Study

Author

Vos, A.C.W., Bakkal, N., Minnee, R.C., Casparie, M.K., Jong, D.J. de, Dijkstra, G., Stokkers, P., Bodegraven, A.A. van, Pierik, M., Woude, C.J. van der, Oldenburg, B., Hommes, D.W., ICC, Other departments, Hematology, Gastroenterology & Hepatology, Interne Geneeskunde, RS: NUTRIM - R2 - Gut-liver homeostasis, Groningen Institute for Gastro Intestinal Genetics and Immunology (3GI), Translational Immunology Groningen (TRIGR), Groningen Institute for Organ Transplantation (GIOT), Gastroenterology and hepatology, and CCA - Innovative therapy

Subjects
Male, Epstein-Barr Virus Infections, Herpesvirus 4, Human, Lymphoma, Azathioprine, Inflammatory bowel disease, Cohort Studies, Risk Factors, hemic and lymphatic diseases, Immunology and Allergy, Child, Netherlands, Aged, 80 and over, Crohn's disease, 6-MERCAPTOPURINE, Thiopurine methyltransferase, biology, Mercaptopurine, Incidence, Gastroenterology, ASSOCIATION, Middle Aged, Prognosis, CANCER, CROHNS-DISEASE, Survival Rate, Child, Preschool, malignant lymphoma, Female, Immunosuppressive Agents, medicine.drug, Adult, medicine.medical_specialty, Adolescent, Molecular gastro-enterology and hepatology Pathogenesis and modulation of inflammation [IGMD 2], Young Adult, Internal medicine, BENEFITS, medicine, Epstein-Barr virus, Humans, IMMUNOSUPPRESSIVE THERAPY, COHORT, Epstein–Barr virus infection, ulcerative colitis, Aged, HODGKINS-DISEASE, business.industry, Infant, Newborn, Case-control study, Infant, Inflammatory Bowel Diseases, medicine.disease, RHEUMATOID-ARTHRITIS, Case-Control Studies, Relative risk, Immunology, biology.protein, business, malignant lymphoma Crohn's disease ulcerative colitis inflammatory bowel diseases Epstein-Barr virus rheumatoid-arthritis immunosuppressive therapy hodgkins-disease crohns-disease azathioprine cancer 6-mercaptopurine association benefits cohort, Follow-Up Studies
Abstract

BACKGROUND:: Immune suppressant medications such as thiopurines and anti-tumor necrosis factor agents are important for maintaining disease control in most patients with inflammatory bowel diseases (IBDs); however, their use has been associated with the development of malignant lymphoma. The purpose of this Dutch nationwide study was to estimate the relative risk of malignant lymphoma in IBD patients. METHODS:: IBD patients who developed a lymphoma between 1997 and 2004 were identified using the Dutch National Database of PALGA. Data from confirmed cases were collected from individual hospitals, including data on Epstein-Barr virus (EBV). The age-adjusted 8-year incidence of malignant lymphoma in the Netherlands was retrieved from the Central Bureau of Statistics. RESULTS:: Forty-two hospitals were visited and 285 matches evaluated in the total cohort of 17,834 IBD patients. Forty-four lymphomas were observed, resulting in a relative risk of 1.27 (95% confidence interval [CI]: 0.92-1.68). Only 19 of 44 patients (43%) were exposed to azathioprine/6-mercaptopurine (AZA/6-MP). Remarkably, 92% of patients (11/12) with EBV-positive lymphoma used AZA/6-MP, in contrast to only 19% patients (4/21) with EBV-negative lymphoma, suggesting a strong relation between EBV-positive lymphoma and thiopurine use. CONCLUSIONS:: This nationwide study does not suggest a significant overall increased risk for lymphoma in IBD patients. A distinct correlation between EBV-positive lymphoma and AZA/6-MP use was observed. (Inflamm Bowel Dis 2011;).

Published
2011

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