{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T03:08:07Z","timestamp":1790046487978,"version":"4.0.1"},"reference-count":25,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2017,3,1]],"date-time":"2017-03-01T00:00:00Z","timestamp":1488326400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2017,3,1]],"date-time":"2017-03-01T00:00:00Z","timestamp":1488326400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["UEG Journal"],"published-print":{"date-parts":[[2017,3]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Refractory coeliac disease type II (RCDII) frequently transforms into an enteropathy\u2010associated T\u2010cell lymphoma (EATL) and therefore requires intensive treatment. Current evaluated treatment strategies for RCDII include cladribine (2\u2010CdA) and autologous stem cell transplantation (auSCT).<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>The purpose of this study was to evaluate long\u2010term survival and define clear prognostic criteria for EATL development comparing two treatment strategies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 45 patients were retrospectively analysed. All patients received 2\u2010CdA, after which they were either closely monitored (monotherapy, <jats:italic>n<\/jats:italic> \u2009=\u200930) or a step\u2010up approach was used including auSCT (step\u2010up therapy, <jats:italic>n<\/jats:italic> \u2009=\u200915).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Ten patients (22%) ultimately developed EATL; nine of these had received monotherapy. Absence of histological remission after monotherapy was associated with EATL development (<jats:italic>p<\/jats:italic> \u2009=\u20090.010). Overall, 20 patients (44%) died with a median survival of 84\u00a0months. Overall survival (OS) within the monotherapy group was significantly worse in those without histological remission compared to those with complete histological remission(<jats:italic>p<\/jats:italic> \u2009=\u20090.030). The monotherapy group who achieved complete histological remission showed comparable EATL occurrence and OS as compared to the step\u2010up therapy group (<jats:italic>p<\/jats:italic> \u2009=\u20090.80 and <jats:italic>p<\/jats:italic> \u2009=\u20090.14 respectively).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Histological response is an accurate parameter to evaluate the effect of 2\u2010CdA therapy and this parameter should be leading in the decisions whether or not to perform a step\u2010up treatment approach in RCDII.<\/jats:p><\/jats:sec>","DOI":"10.1177\/2050640616646529","type":"journal-article","created":{"date-parts":[[2016,4,29]],"date-time":"2016-04-29T06:12:48Z","timestamp":1461910368000},"page":"208-217","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":36,"title":["Lymphoma development and survival in refractory coeliac disease type II: Histological response as prognostic factor"],"prefix":"10.1002","volume":"5","author":[{"given":"P","family":"Nijeboer","sequence":"first","affiliation":[{"name":"Department of Gastroenterology VU University Medical Centre Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"RLJ","family":"van Wanrooij","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology VU University Medical Centre Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T","family":"van Gils","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology VU University Medical Centre Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"NJ","family":"Wierdsma","sequence":"additional","affiliation":[{"name":"Department of Nutrition and Dietetics VU University Medical Centre Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"GJ","family":"Tack","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology VU University Medical Centre Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"BI","family":"Witte","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics VU University Medical Centre Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"HJ","family":"Bontkes","sequence":"additional","affiliation":[{"name":"Department of Pathology VU University Medical Centre Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"O","family":"Visser","sequence":"additional","affiliation":[{"name":"Department of Haematology VU University Medical Centre Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"CJJ","family":"Mulder","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology VU University Medical Centre Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G","family":"Bouma","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology VU University Medical Centre Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,3]]},"reference":[{"key":"e_1_2_7_2_2","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2006.114512"},{"key":"e_1_2_7_3_2","doi-asserted-by":"crossref","unstructured":"When is a coeliac a coeliac? 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