We present three cases of the rare hepatosplenic T-cell lymphoma (HSTCL); two patients suffering from Crohn disease who developed HSTCL on azathioprine without exposure to biologicals, and a third patient who had psoriasis treated using etanercept, cyclosporine and methotrexate. The evidence for an association between HSTCL and immunosuppressive drugs and biologicals is reviewed. We argue for improved pharmacovigilance processes to help determine the benefit to risk ratios for the use of these and other new agents.
Keywords: biologicals; hepatosplenic T-cell lymphoma; immunosuppression; inflammatory bowel disease; psoriasis.
© 2014 The Authors; Internal Medicine Journal © 2014 Royal Australasian College of Physicians.