A148 EBV STATUS AND IMMUNOSUPPRESSANT USE IN IBD PATIENTS WHO SUBSEQUENTLY DEVELOP LYMPHOMA: A RETROSPECTIVE AND PROSPECTIVE STUDY
Bibliographic record
Abstract
Immunosuppressive agents have revolutionized the treatment of inflammatory bowel disease (IBD). However, a number of studies over the last decade have identified a concerning link between immunosuppression and lymphoproliferative disorders (LPDs). These LPDs have been associated with Epstein-Barr virus (EBV) infection in which the virus provides the impetus for malignant transformation while immunosuppression hampers the immune system’s ability to detect and clear these malignant cells. There is limited knowledge on LPD risk in individuals with IBD. This study is conducted to determine if immunosuppressive therapy in the IBD population increases the risk of LPDs. This study is divided into two arms: a retrospective and a prospective study. A retrospective chart review was conducted on IBD patients in Alberta from 2005–2015. Alberta Cancer Registry (ACR) and Electronic Medical Records (EMRs) used by the IBD team at the University of Alberta Hospital were searched with keywords “lymphoma” and “IBD”. Patient age, gender, year of IBD diagnosis, year of lymphoma diagnosis, and type of lymphoma data were obtained. An ongoing prospective study has followed patients from the IBD Clinic and the University of Alberta Hospital from 2016 to present. Initial EBV serologies were completed at baseline. Patients are to be followed-up for 3 years to determine if seroconversion and immunosuppression confer increased risk of LPD development. In total, 209 patients have been enrolled in this study; 176 (84.2%) have been screened, while 33 (15.8%) are pending results. Of the 176 screened, 108 (61.4%) are female. Ninety (51.1%) patients are diagnosed with Crohn’s disease, 79 (44.9%) with Ulcerative Colitis, and 7 (4.0%) with Indeterminate Colitis. The EBV serology results showed 9.1% (16) of patients with negative exposure, 72.7% (128) with past exposure, 9.7% (17) with indeterminate IgM, while 1.1% (2) had a positive viral load. Of the 16 patients with negative exposure, 10 (62.5%) were on biologics, 8 (50%) on an immunomodulatory, and 6 (37.5%) were on both. Retrospectively, 14 patients (9 male) had developed lymphoma. Positive EBV histology was found in 3 (21.4%) patients. These interim results suggest that LPD remains a small but possible risk of immunosuppressant use in IBD patients. The utilization of an EBV serologic monitoring protocol may help to identify those at the highest risk of LPD development. Type of immunosuppressant therapy in the seronegative population CEGIIR (The Center of Excellence for Gastrointestinal Inflammation and Immunity Research)
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".