Epstein-Barr virus, lymphoma risk and the potential role of HIV infection in IBD patients undergoing immunosuppression.

For decades, lymphoma has been considered a dreaded and untoward complication of autoimmune disorders, including inflammatory bowel disease (IBD). Yet until recently, the data linking inflammatory bowel disease with an increased risk for lymphoma has been equivocal. With the publication of the CESAME trial in 2009, a greater understanding of lymphoma risk has begun to emerge. In this Falk Symposium paper, I discuss the available data from studies that interrogated the relationship between lymphoma and IBD, thiopurines and TNFα-directed agents. While recent data has clarified some aspects of lymphoma epidemiology in patients with IBD, causality and the mechanisms that underlie it remain very poorly understood.