Skip Navigation LinksHome > February 2014 - Volume 20 - Issue 2 > Malignancy and Mortality in Pediatric Patients with Inflamma...
Inflammatory Bowel Diseases:
doi: 10.1097/01.MIB.0000439066.69340.3c
Original Clinical Articles

Malignancy and Mortality in Pediatric Patients with Inflammatory Bowel Disease: A Multinational Study from the Porto Pediatric IBD Group

de Ridder, Lissy MD, PhD1; Turner, Dan MD, PhD2; Wilson, David C. MD, PhD3; Koletzko, Sibylle MD4; Martin-de-Carpi, Javier MD, PhD5; Fagerberg, Ulrika L. MD, PhD6,7; Spray, Christine MBChB8; Sladek, Malgorzata MD, PhD9; Shaoul, Ron MD, PhD10; Roma-Giannikou, Eleftheria MD, PhD11; Bronsky, Jiri MD, PhD12; Serban, Daniela E. MD, PhD13; Cucchiara, Salvatore MD, PhD14; Veres, Gabor MD, PhD15; Ruemmele, Frank M. MD, PhD16; Hojsak, Iva MD, PhD17; Kolho, Kaija L. MD, PhD18; Davies, Ieuan H. MA19; Aloi, Marina MD, PhD20; Lionetti, Paolo MD, PhD21; Veereman-Wauters, Gigi MD, PhD22; Braegger, Christian P. MD, PhD23; Trindade, Eunice MD, PhD24; Wewer, Anne V. MD, PhD25; Hauer, Almuthe MD, PhD26; Levine, Arie MD, PhD27

Collapse Box

Abstract

Background:

The combination of the severity of pediatric-onset inflammatory bowel disease (IBD) phenotypes and the need for intense medical treatment may increase the risk of malignancy and mortality, but evidence regarding the extent of the problem is scarce. Therefore, the Porto Pediatric IBD working group of ESPGHAN conducted a multinational-based survey of cancer and mortality in pediatric IBD.

Methods:

A survey among pediatric gastroenterologists of 20 European countries and Israel on cancer and/or mortality in the pediatric patient population with IBD was undertaken. One representative from each country repeatedly contacted all pediatric gastroenterologists from each country for reporting retrospectively cancer and/or mortality of pediatric patients with IBD after IBD onset, during 2006–2011.

Results:

We identified 18 cases of cancers and/or 31 deaths in 44 children (26 males) who were diagnosed with IBD (ulcerative colitis, n = 21) at a median age of 10.0 years (inter quartile range, 3.0–14.0). Causes of mortality were infectious (n = 14), cancer (n = 5), uncontrolled disease activity of IBD (n = 4), procedure-related (n = 3), other non-IBD related diseases (n = 3), and unknown (n = 2). The most common malignancies were hematopoietic tumors (n = 11), of which 3 were hepatosplenic T-cell lymphoma and 3 Ebstein–Barr virus–associated lymphomas.

Conclusions:

Cancer and mortality in pediatric IBD are rare, but cumulative rates are not insignificant. Mortality is primarily related to infections, particularly in patients with 2 or more immunosuppressive agents, followed by cancer and uncontrolled disease. At least 6 lymphomas were likely treatment-associated by virtue of their phenotype.

Copyright © 2013 Crohn's & Colitis Foundation of America, Inc.

You currently do not have access to this article.

You may need to:

Note: If your society membership provides for full-access to this article, you may need to login on your society’s web site first.

Login

Search for Similar Articles
You may search for similar articles that contain these same keywords or you may modify the keyword list to augment your search.