Ankylosing Spondylitis in Association with Non-Hodgkin's Lymphoma : Successful Anti-TNF Alpha Treatment

Some rheumatic diseases, including ankylosing spondylitis, appear to be associated to an increased risk of cancer, in particular lymphoma. At the same time, a slightly higher risk of cancer has been associated to Tumour Necrosis Factor (TNF)-alpha antagonists, a widely used treatment for ankylosing spondylitis. A history of malignancy is generally considered a contraindication to TNF-alpha inhibitor and, if neoplasia is uncovered during treatment, therapy suspension is mandatory. Few data are available regarding the possibility of resuming treatment in the event of a flare up of this disease, even when exams monitoring the neoplastic disease are negative. Here we describe the case of a 56-year-old AS patient who developed a cutaneous B-cell non-Hodgkin lymphoma while undergoing treatment with a TNF-alpha inhibitor. The therapy was suspended while he was treated for the neoplasia, but it was resumed when there was a flare up of the disease, and the patient showed improvement.