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Owing to recent advances in the understanding of IBD, immunosuppressive agents (mainly against TNF\u03b1 directed) as well as biological drugs are more and more often used. This therapeutic approach clearly improved the clinical condition of the majority of patients with IBD. However, with this more aggressive treatment strategy, safety concerns clearly arise. Recently, the description of a series of a particularly severe form of T cell lymphoma in pediatric and young adult patients with IBD under immunomodulator and biological combination therapy raised the question of the risks of treatment\u2010induced side effects or complications. As reviewed in the present article, there is a slightly increased risk of not only lymphoma development in IBD patients, potentially related to the inflammatory process, but also to the use of immunosuppressive therapies. On the basis of the literature data, we reanalyzed current treatment strategies for children with moderate\u2010to\u2010severe IBD, who are candidates to receive immunomodulator and\/or biological agents potentially accelerating the risk of lymphoma development. Comparative clinical studies in IBD are still missing; however, it is prudent to think about adapting immunosuppressive therapies to the inflammatory process of the underlying disorder and if possible to reduce them to monotherapy. Alternative treatment strategies for heavy immunosuppression exist (eg, enteral nutrition in Crohn disease or colectomy in patients with ulcerative colitis) and should be considered whenever appropriate. There is a major need for comparative studies before evidence\u2010based guidelines can be established for safest and best treatment strategies of pediatric patients with IBD.<\/jats:p><\/jats:sec>","DOI":"10.1097\/mpg.0b013e31818cf555","type":"journal-article","created":{"date-parts":[[2009,5,21]],"date-time":"2009-05-21T13:29:05Z","timestamp":1242912545000},"page":"257-267","source":"Crossref","is-referenced-by-count":39,"title":["Pediatric Inflammatory Bowel Diseases and the Risk of Lymphoma: Should We Revise Our Treatment Strategies?"],"prefix":"10.1002","volume":"48","author":[{"given":"Salvatore","family":"Cucchiara","sequence":"first","affiliation":[{"name":"Pediatric Gastroenterology Unit University of Rome La Sapienza University Hospital Umberto I Rome Italy"}]},{"given":"Johanna C","family":"Escher","sequence":"additional","affiliation":[{"name":"Department of Pediatric Gastroenterology Sophia Children's Hospital\u2010Erasmus Medical Center Rotterdam The Netherlands"}]},{"given":"Hans","family":"Hildebrand","sequence":"additional","affiliation":[{"name":"Department of Women and Child Health Astrid Lindgren Children's Hospital Stockholm Sweden"}]},{"given":"Jorge","family":"Amil\u2010Dias","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Pediatric Gastroenterology Hospital S. Jo\u00e3o Porto Portugal"}]},{"given":"Laura","family":"Stronati","sequence":"additional","affiliation":[{"name":"Pediatric Gastroenterology Unit University of Rome La Sapienza University Hospital Umberto I Rome Italy"}]},{"given":"Frank M","family":"Ruemmele","sequence":"additional","affiliation":[{"name":"AP\u2010HP H\u00f4pital Necker\u2010Enfants Malades Department of Pediatrics Pediatric Gastroenterology"},{"name":"Universit\u00e9 Paris\u2010Descartes Facult\u00e9 de M\u00e9decine Necker INSERM U793 Paris France"}]}],"member":"311","published-online":{"date-parts":[[2009,3]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)60751-X"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.MPG.0000154660.62359.FE"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1746.2005.03832.x"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11894-006-0040-6"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/ibd.20211"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11894-006-0041-5"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.2165\/00003495-200767120-00005"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1038\/ncpgasthep0695"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPG.0b013e31802f6424"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/ibd.20169"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.22719"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1080\/10428190500420973"},{"key":"e_1_2_8_14_1","unstructured":"HarrisNL SteinH CouplandSE et al. 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