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Dario Sorrentino, MD; Giovanni Terrosu, MD; Claudio Avellini, MD

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In reply

We thank Roblin and Phelip for their comment on a timely issue. The recent report of the rare hepatosplenic T-cell lymphoma (HSTCL) in young patients with CD treated with both infliximab and azathioprine or steroids¹ has rightly unleashed a series of doubts regarding the optimal use of biological agents in this and other conditions.² How these observations may directly relate to the design of our study³—as implied by Roblin and Phelip—is unclear though. While azathioprine by itself has been linked to lymphoma development including HSTCL,¹ recent studies have shown that neither infliximab nor methotrexate, which was used in our study, alone or in combination in CD⁴ or in rheumatoid arthritis,⁵ appear to be associated with an increased risk of developing lymphomas. In addition, methotrexate alone has never been associated thus far with HSTCL in CD.¹

The report by . . . [Full Text of this Article]

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