Abstract
Patients with rheumatoid arthritis often develop methotrexate-associated lymphoproliferative disorders (MTX-LPD) during MTX treatment. MTX-LPD occasionally regresses spontaneously after simply discontinuing MTX treatment. In patients without spontaneous regression, additional chemotherapy is required to avoid disease progression. However, the differences between spontaneous and non-spontaneous regression have yet to be elucidated. To clarify the factors important for spontaneous regression, we analyzed the clinicopathological features of 51 patients with rheumatoid arthritis who developed MTX-LPD (diffuse large B-cell lymphoma [DLBCL]-type [n = 34] and classical Hodgkin lymphoma [CHL]-type [n = 17]). We examined the interval from MTX discontinuation to the administration of additional chemotherapy. The majority of DLBCL-type MTX-LPD patients (81%) exhibited remission with MTX discontinuation alone. In contrast, the majority of CHL-type MTX-LPD patients (76%) required additional chemotherapy. This difference was statistically significant (P = 0.001). However, overall survival was not significantly different between DLBCL-type and CHL-type (91% vs 94%, respectively; P > 0.05). Thus, the morphological differences in the pathological findings of MTX-LPD may be a factor for spontaneous or non-spontaneous regression after discontinuation of MTX.
| Original language | English |
|---|---|
| Pages (from-to) | 1271-1280 |
| Number of pages | 10 |
| Journal | Cancer Science |
| Volume | 108 |
| Issue number | 6 |
| DOIs | |
| Publication status | Published - Jun 1 2017 |
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Keywords
- Epstein-Barr virus
- histological findings
- methotrexate-associated lymphoproliferative disorders
- rheumatoid arthritis
- spontaneous remission
ASJC Scopus subject areas
- Oncology
- Cancer Research
Cite this
Clinicopathological analysis of methotrexate-associated lymphoproliferative disorders : Comparison of diffuse large B-cell lymphoma and classical Hodgkin lymphoma types. / Gion, Yuka; Iwaki, Noriko; Takata, Katsuyoshi; Takeuchi, Mai; Nishida, Keiichiro; Orita, Yorihisa; Tachibana, Tomoyasu; Yoshino, Tadashi; Sato, Yasuharu.
In: Cancer Science, Vol. 108, No. 6, 01.06.2017, p. 1271-1280.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Clinicopathological analysis of methotrexate-associated lymphoproliferative disorders
T2 - Comparison of diffuse large B-cell lymphoma and classical Hodgkin lymphoma types
AU - Gion, Yuka
AU - Iwaki, Noriko
AU - Takata, Katsuyoshi
AU - Takeuchi, Mai
AU - Nishida, Keiichiro
AU - Orita, Yorihisa
AU - Tachibana, Tomoyasu
AU - Yoshino, Tadashi
AU - Sato, Yasuharu
PY - 2017/6/1
Y1 - 2017/6/1
N2 - Patients with rheumatoid arthritis often develop methotrexate-associated lymphoproliferative disorders (MTX-LPD) during MTX treatment. MTX-LPD occasionally regresses spontaneously after simply discontinuing MTX treatment. In patients without spontaneous regression, additional chemotherapy is required to avoid disease progression. However, the differences between spontaneous and non-spontaneous regression have yet to be elucidated. To clarify the factors important for spontaneous regression, we analyzed the clinicopathological features of 51 patients with rheumatoid arthritis who developed MTX-LPD (diffuse large B-cell lymphoma [DLBCL]-type [n = 34] and classical Hodgkin lymphoma [CHL]-type [n = 17]). We examined the interval from MTX discontinuation to the administration of additional chemotherapy. The majority of DLBCL-type MTX-LPD patients (81%) exhibited remission with MTX discontinuation alone. In contrast, the majority of CHL-type MTX-LPD patients (76%) required additional chemotherapy. This difference was statistically significant (P = 0.001). However, overall survival was not significantly different between DLBCL-type and CHL-type (91% vs 94%, respectively; P > 0.05). Thus, the morphological differences in the pathological findings of MTX-LPD may be a factor for spontaneous or non-spontaneous regression after discontinuation of MTX.
AB - Patients with rheumatoid arthritis often develop methotrexate-associated lymphoproliferative disorders (MTX-LPD) during MTX treatment. MTX-LPD occasionally regresses spontaneously after simply discontinuing MTX treatment. In patients without spontaneous regression, additional chemotherapy is required to avoid disease progression. However, the differences between spontaneous and non-spontaneous regression have yet to be elucidated. To clarify the factors important for spontaneous regression, we analyzed the clinicopathological features of 51 patients with rheumatoid arthritis who developed MTX-LPD (diffuse large B-cell lymphoma [DLBCL]-type [n = 34] and classical Hodgkin lymphoma [CHL]-type [n = 17]). We examined the interval from MTX discontinuation to the administration of additional chemotherapy. The majority of DLBCL-type MTX-LPD patients (81%) exhibited remission with MTX discontinuation alone. In contrast, the majority of CHL-type MTX-LPD patients (76%) required additional chemotherapy. This difference was statistically significant (P = 0.001). However, overall survival was not significantly different between DLBCL-type and CHL-type (91% vs 94%, respectively; P > 0.05). Thus, the morphological differences in the pathological findings of MTX-LPD may be a factor for spontaneous or non-spontaneous regression after discontinuation of MTX.
KW - Epstein-Barr virus
KW - histological findings
KW - methotrexate-associated lymphoproliferative disorders
KW - rheumatoid arthritis
KW - spontaneous remission
UR - http://www.scopus.com/inward/record.url?scp=85019965631&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85019965631&partnerID=8YFLogxK
U2 - 10.1111/cas.13249
DO - 10.1111/cas.13249
M3 - Article
C2 - 28380678
AN - SCOPUS:85019965631
VL - 108
SP - 1271
EP - 1280
JO - Cancer Science
JF - Cancer Science
SN - 1347-9032
IS - 6
ER -