From: Ron Hoggan
Date: Thu, 11 Jul 1996
Subject: non-Hodgkin's lymphoma

"Coeliac disease is sometimes referred to as a pre-malignant condition."(1) "An increased risk of malignancy has been definitely established in coeliac disease; these patients are reported to have a 40 to 100-fold risk of developing non-Hodgkin's lymphoma."(2) In fact, since 1971, we have known that the untreated celiac's immune system, lacks the normal lymphocyte reaction to malignant cells. Maclaurin et.al. placed blood samples in test tubes, then added tumor cells from a lymphoma cell line. The blood from controls reacted in a cytotoxic manner, while the blood from celiacs reacted minimally or not at all.(3) In plain language, our immune systems seem to lack the necessary elements to attack malignant cells, and we are especially at-risk for lymphomas. I should point out that Maclaurin found no difference between treated and untreated celiacs, but this work was done prior to 1971, and many glutinous substances were still allowed in the gluten-free diet of that time and place.

Since that time, Holmes et.al. have demonstrated that the gluten-free diet does serve a protective role against malignancy.(4) In fact, Egan et. al. state: "Failure to recognize CS [celiac sprue] and exclude gluten from the diet of a patient with CAL will seriously jeopardize the chance of recovery."(5) The most common celiac-associated lymphoma is T cell, usually occurring in the gastrointestinal tract. (6,7) Another group has proposed that celiac disease itself is the result of a low grade lymphoma.(9) That would imply that the gluten free diet may have a reversing effect on the dynamic that leads to malignancy. Certainly that is suggested by several of the findings cited.

Wright et. al. cite one case where the gluten-free diet resulted in full remission for a 59 year-old patient. Their claim is hotly debated in the literature, but since they have saved a resected segment of the bowel, which is malignant, there is little room for dispute(9). Another group reports the disappearance of a lyphadenopathy with a gluten-free diet. While they had originally diagnosed it as lymphoma, the fact that it went away on the gluten-free diet convinced them that it could not have been malignant.(10)

I urgently suggest that you get tested for celiac disease, and if it is positive, follow the diet very strictly. My brother has B cell lymphoma, and because most celiac-associated lymphomas are T cell, the doctors have scoffed at my suggestion/request that they test him for celiac disease. Perhaps you can benefit from all the long hours I spent pouring over medical journals to find evidence to support my request. I wish you well, and would welcome hearing from you in future.

Sources:

1. Tigh M, Ciclitira P. "The implications of recent advances in coeliac disease" Acta Paediatr 1993; 82: 805-810
2. Collin, et. al. "Coeliac disease-associated disorders and survival" Gut 1994; 35:1215-1218
3. Maclaurin et. al. "Inpaired lymphocyte reactivity against tumour cells in patients with coeliac disease" Gut 1971; 12: 794-800
4. Holmes, et. al. "Malignancy in coeliac disease - effect of a gluten free diet" Gut 1989; 30: 333-338
5. Egan et. al. "Celiac-Associated Lymphoma" J. Clin. Gastroenterol 1995; 21(2): 123-129
6. Wright D, "The major complications of coeliac disease" Bailliere's Clinical Gastroenterology 1995; 9(2): 351-369
7. Mathus-Vliegen et. al. "Malignant lymphoma in coeliac disease: various manifestations with distinct symptomatology and prognosis?" Journal of Internal Medicine 1994; 236: 43-49
8. Wright et. al. "Coelaic disease and lymphoma" Lancet 1991; 338: 318-319
9. Wright et. al "Coeliac disease and lymphoma" Lancet 1991; 337: 1373
10. de Boer et. al. "Disappearance of Mesenteric Lymphadenopathy with Gluten-Free diet in Celiac Sprue" J. Clin. Gastroenterol 1993; 16(4): 317-319

I hope that is helpful,

Ron Hoggan