CELIAC DISEASE AND LYMPHOMA

Celiac Disease Linked to High Risk of Non-Hodgkin Lymphoma

NEW YORK (Reuters Health) Feb 04 - Analysis of data from Swedish cancer registry shows a more than 5-fold increased risk of non-Hodgkin lymphoma (NHL) in patients with celiac disease in the most recent evaluation period. Nonetheless, the risk is steadily decreasing, and is less than half of what it was 40 years ago.

Researchers with the National Cancer Institute in Bethesda, Maryland, and the Karolinska Institute in Sweden conducted a case-control study of more than 60,000 patients with lymphomas diagnosed in Sweden between 1965 and 2004.

Dr. Ying Gao of NCI and colleagues identified 37,869 cases of NHL, 8,323 cases of Hodgkin lymphoma (HL), 13,842 cases of chronic lymphocytic leukemia (CLL), 236,408 matched controls and 613,961 first-degree relatives. Patients with a prior history of celiac disease were identified though hospital discharge data.

"Overall, we found persons with a hospital discharge diagnosis of celiac disease to have a 5.35-fold increased NHL risk," the team reports in the January issue of Gastroenterology. Risk of HL was "borderline increased" and there was no increased risk of CLL in celiac disease patients.

The risk of NHL in patients with celiac disease was increased 13.2-fold between 1975-1984, 7.90-fold between 1985-1994, and 3.84-fold between 1995-2004.

Individuals with a sibling affected with celiac disease had a 2.03-fold increased risk of NHL.

"At this time, we do not know what the actual cause of the link is," Dr. Gao told Reuters Health. "Prior studies have suggested that celiac disease leads to inflammation and that inflammation drives development of lymphomas."

"There are two key messages of our study," Dr. Gao said. "First, due to early detection of celiac disease, individuals with a diagnosis of celiac disease have a lower risk of developing lymphoma compared with the past, when celiac disease was detected at a more severe state and consequently, the risk of lymphomas was higher."

"Second, persons with a family history of celiac disease had a higher risk of developing lymphoma. This familial association was independent of a personal history of celiac disease. Taken together, these findings suggest that there might be some underlying mechanisms that lead to both celiac disease and lymphoma," Dr. Gao concluded.