Diario de columna vertebral

Ankylosing Spondylitis in Association with Non-Hodgkin's Lymphoma : Successful Anti-TNF Alpha Treatment

Abstract

Augusta Ortolan, Anna La Salvia, Mariagrazia Lorenzin, Paola Frallonardo, Dario Marino, Leonardo Punzi and Roberta Ramonda

Some rheumatic diseases, including ankylosing spondylitis, appear to be associated to an increased risk of cancer, in particular lymphoma. At the same time, a slightly higher risk of cancer has been associated to Tumour Necrosis Factor (TNF)-alpha antagonists, a widely used treatment for ankylosing spondylitis. A history of malignancy is generally considered a contraindication to TNF-alpha inhibitor and, if neoplasia is uncovered during treatment, therapy suspension is mandatory. Few data are available regarding the possibility of resuming treatment in the event of a flare up of this disease, even when exams monitoring the neoplastic disease are negative. Here we describe the case of a 56-year-old AS patient who developed a cutaneous B-cell non-Hodgkin lymphoma while undergoing treatment with a TNF-alpha inhibitor. The therapy was suspended while he was treated for the neoplasia, but it was resumed when there was a flare up of the disease, and the patient showed improvement.