{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,17]],"date-time":"2025-12-17T08:32:28Z","timestamp":1765960348636,"version":"build-2065373602"},"reference-count":47,"publisher":"MDPI AG","issue":"20","license":[{"start":{"date-parts":[[2024,10,20]],"date-time":"2024-10-20T00:00:00Z","timestamp":1729382400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Autoimmune hepatitis (AIH) is a chronic inflammatory liver disease caused by an autoimmune attack on hepatocytes. The first-line treatment for AIH comprises two core components: glucocorticoids and thiopurine analog inhibitors and mycophenolate mofetil (MMF). Numerous studies have suggested an increased risk for lymphoma among patients with either rheumatoid arthritis or inflammatory bowel disease (IBD) who are treated with azathioprine\/6-mercaptopurine (6-MP). The relative risk of non-Hodgkin lymphoma (NHL) among autoimmune hepatitis patients treated with these immunosuppressive drugs remains unclear. We aimed at investigating the risk of NHL across a large retrospective AIH cohort after a long-term follow-up. Methods: This retrospective, population-based study comprised approximately 2.7 million adults over two decades. It included adult patients aged 20 years or older at the time of autoimmune hepatitis diagnosis who had initiated treatment with azathioprine, 6-MP, or MMF. The primary outcome was the development of non-Hodgkin lymphoma. Results: The study initially included 834 patients diagnosed with AIH. A total of 685 patients remained in the research cohort after matching the data to the local cancer registry. Compared to the predicted NHL rate in the general population, NHL incidence was considerably higher in AIH patients (Standardized Incidence Ratio, SIR = 36.5). Subgroup studies showed that lymphoma mainly affected patients 45 years of age and over and was detected primarily during the first seven years following the AIH diagnosis. No correlation was found between the incidence of NHL and the treatment drug used. Conclusions: Patients with AIH exhibit a markedly higher risk of NHL compared to the general population.<\/jats:p>","DOI":"10.3390\/jcm13206258","type":"journal-article","created":{"date-parts":[[2024,10,21]],"date-time":"2024-10-21T10:49:22Z","timestamp":1729507762000},"page":"6258","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Increased Risk of Non-Hodgkin Lymphoma in Autoimmune Hepatitis: A Large Retrospective Cohort Study"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-9865-0785","authenticated-orcid":false,"given":"Mifleh","family":"Tatour","sequence":"first","affiliation":[{"name":"Clalit Health Services, Nof Hagalil 1710601, Israel"},{"name":"Department of Family Medicine, Clalit Health Services, Afula 1710601, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6967-6947","authenticated-orcid":false,"given":"Ziv","family":"Neeman","sequence":"additional","affiliation":[{"name":"Imaging Institute & Nuclear Medicine, Emek Medical Center, Clalit Health Services, Afula 183411, Israel"},{"name":"Ruth and Bruce Rappaport, Faculty of Medicine, Technion\u2014Institute of Technology, Haifa 3109601, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6024-1100","authenticated-orcid":false,"given":"Ariel","family":"Aviv","sequence":"additional","affiliation":[{"name":"Ruth and Bruce Rappaport, Faculty of Medicine, Technion\u2014Institute of Technology, Haifa 3109601, Israel"},{"name":"Hematology Unit, HaEmek Medical Center, Afula 183411, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7731-118X","authenticated-orcid":false,"given":"Rawi","family":"Hazzan","sequence":"additional","affiliation":[{"name":"Clalit Health Services, Nof Hagalil 1710601, Israel"},{"name":"Azrieli Faculty of Medicine, Bar-Ilan University, Safed 1311502, Israel"},{"name":"Emek Medical Center, 21 Yitzhak Rabin Blvd, Afula 183411, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,10,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"18017","DOI":"10.1038\/nrdp.2018.17","article-title":"Autoimmune hepatitis","volume":"4","author":"Vergani","year":"2018","journal-title":"Nat. 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