Aggressive medical therapy might be more closely linked to mortality and malignancy in pediatric inflammatory bowel disease than the condition itself, according to a new study.
Malignancy and mortality are the most serious complications among pediatric inflammatory bowel disease (IBD) patients, and a new study has found that these outcomes are mostly linked to intense medical treatment, not the condition.
The investigators, part of the Porto Pediatric IBD working group of the European Society of Paediatric Gastroenterology, Hepatology and Nutrition, surveyed pediatric gastroenterologists of 20 European countries and Israel on cancer and mortality in pediatric IBD patients and .
From 2006-2011 all pediatric gastroenterologists from the 21 countries retrospectively reported cancer and/or mortality of pediatric IBD patients after the onset of the condition. According to the researchers, the severity of the disease and the need for aggressive treatment may increase malignancy and mortality.
“Cancer and mortality in pediatric IBD are rare, but cumulative rates are not insignificant,” the researchers wrote. “Mortality is primarily related to infections, particularly in patients with 2 or more immunosuppressive agents, followed by cancer and uncontrolled disease.”
Eighteen cases of cancers and/or 31 deaths were identified in 44 children diagnosed with IBD at a median age of 10 years. According to the data, 21 patients had ulcerative colitis and 26 patients were male. Causes of death among the pediatric patients were infections (n= 14), cancer (n= 5), uncontrolled disease activity of IBD (n= 4), procedure-related (n= 3), other non-IBD-related diseases (n= 3) and unknown (n= 2).
The most common malignancies reported were hematopoietic tumors (n= 11).
Larger scale studies on the rare but severe outcomes of pediatric IBD are necessary to determine more, according to the researchers, who admitted that evidence regarding the extent of mortality or malignancies in pediatric IBD is scarce.