TY - JOUR
T1 - Clinicopathologic investigation of methotrexate-induced lymphoproliferative disorders, with a focus on regression
AU - Tokuhira, Michihide
AU - Saito, Shuntaro
AU - Okuyama, Ayumi
AU - Suzuki, Katsuya
AU - Higashi, Morihiro
AU - Momose, Shuji
AU - Shimizu, Takayuki
AU - Mori, Takehiko
AU - Anan-Nemoto, Tomoe
AU - Amano, Koichi
AU - Okamoto, Shinichiro
AU - Takeuchi, Tsutomu
AU - Tamaru, Jun Ichi
AU - Kizaki, Masahiro
N1 - Funding Information:
This study was funded by the University Grant of Saitama Medical University under the grant number 25-B-1-12.
Publisher Copyright:
© 2017 Informa UK Limited, trading as Taylor & Francis Group.
PY - 2018/5/4
Y1 - 2018/5/4
N2 - Although recent accumulative data reveal the clinicopathogenesis of regression in methotrexate-induced lymphoproliferative disorders (MTX-LPDs), the precise understanding including this category remains controversial. In this study, we analyzed 62 patients with MTX-LPD. Forty-three patients showed regression (Reg group), with high rates of Hodgkin lymphoma (HL) and LPD (90 and 88%, respectively). Among the 43 patients of the Reg group, 14 patients (33%) relapsed. The median duration before relapse in the Reg group was 10.6 months. Although the difference of OS between the Reg and Non-Reg groups was not significantly different, relapse-free patients in the Reg group had a superior overall survival (OS). MTX duration had a significant impact on Epstein–Barr virus (EBV) infection (p =.00131). Furthermore, EBV infection was significantly related to clinical manifestations, including spleen invasion, in the regression phenomenon. Some human leukocyte antigens (HLA) alleles might affect MTX-LPD development via EBV infection, although A*2402 and DRB1*0405 might be affected as fundamental factors.
AB - Although recent accumulative data reveal the clinicopathogenesis of regression in methotrexate-induced lymphoproliferative disorders (MTX-LPDs), the precise understanding including this category remains controversial. In this study, we analyzed 62 patients with MTX-LPD. Forty-three patients showed regression (Reg group), with high rates of Hodgkin lymphoma (HL) and LPD (90 and 88%, respectively). Among the 43 patients of the Reg group, 14 patients (33%) relapsed. The median duration before relapse in the Reg group was 10.6 months. Although the difference of OS between the Reg and Non-Reg groups was not significantly different, relapse-free patients in the Reg group had a superior overall survival (OS). MTX duration had a significant impact on Epstein–Barr virus (EBV) infection (p =.00131). Furthermore, EBV infection was significantly related to clinical manifestations, including spleen invasion, in the regression phenomenon. Some human leukocyte antigens (HLA) alleles might affect MTX-LPD development via EBV infection, although A*2402 and DRB1*0405 might be affected as fundamental factors.
KW - Methotrexate
KW - autoimmune diseases
KW - lymphoproliferative disorders
KW - regression
KW - rheumatoid arthritis
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U2 - 10.1080/10428194.2017.1369073
DO - 10.1080/10428194.2017.1369073
M3 - Article
C2 - 28877615
AN - SCOPUS:85029422699
SN - 1042-8194
VL - 59
SP - 1143
EP - 1152
JO - Leukemia and Lymphoma
JF - Leukemia and Lymphoma
IS - 5
ER -
