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Hepatosplenic T-cell lymphoma, immunosuppressive agents and biologicals: what are the risks?
K Subramaniam1, D Yeung, F Grimpen
1Gastroenterology and Hepatology Unit, Therapeutic Goods Administration, Canberra, Australian Capital Territory, Australia.
Abstract:
We present three cases of the rare hepatosplenic T-cell lymphoma (HSTCL); two patients suffering from Crohn disease who developed HSTCL on azathioprine without exposure to biologicals, and a third patient who had psoriasis treated using etanercept, cyclosporine and methotrexate. The evidence for an association between HSTCL and immunosuppressive drugs and biologicals is reviewed. We argue for improved pharmacovigilance processes to help determine the benefit to risk ratios for the use of these and other new agents.
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