Lymphoma in inflammatory bowel disease including the risk associated with immunosuppression and patient outcomes

Many studies report a small increase in cancer risk in patients with inflammatory bowel disease (IBD). This may be linked to inflammation itself or to drugs that are used to treat IBD. Although the risk is low, it is important to identify risk factors for cancer so that anyone at risk may be identified and the safest treatment selected for them. One of the cancers associated with IBD is lymphoma, a type of blood cancer developing from lymph node cells (lymphocytes). Lymphoma is a serious and sometimes fatal diagnosis.

A recent study has suggested that the risk of lymphoma is six times higher in IBD patients taking thiopurines compared to patients who do not take these drugs. The specific types of lymphoma and the risk factors associated with it have not been studied in a UK IBD population.

We propose to identify patients in the IBD BioResource who have a diagnosis of lymphoma. We will determine what type of lymphoma occurred and analyse any factors in their lifestyle, their type of IBD and how it was treated, that may have increased risk of lymphoma. This will help us understand the reason that lymphoma developed and how to reduce the risk in future patients.

We would then analyse detailed clinical information in this group including the treatment they received for IBD, the type of lymphoma, how they were treated and the outcomes of treatment.

The overarching aim of the study will be to identify individuals with IBD who are most at risk of developing lymphoma, and personalising their treatment to reduce this risk as much as possible.