Thiopurines and Risk for Lymphoproliferative Disorders

The use of thiopurines and antitumor necrosis–factor agents is generally associated with increased risk for lymphoproliferative disorders (LPDs) in patients with inflammatory bowel disease (IBD). However, the extent of this risk, or whether it exists at all, is controversial. To address this issue, researchers conducted a prospective observational study involving approximately 20,000 IBD patients, of whom 30% were receiving thiopurines, 14% had discontinued thiopurines, and 56% had never received thiopurines.

During median follow-up of 35 months and nearly 50,000 patient-years (including complete follow-up in 85% of patients), 23 patients were diagnosed with LPDs (22 with non-Hodgkin LPDs and 1 with Hodgkin lymphoma). Multivariate analysis r…