Methotrexate-associated Lymphoproliferative Disorders in Patients With Rheumatoid Arthritis: Clinicopathologic Features and Prognostic Factors
| Autor: | Hiroaki Miyoshi, Koji Kato, Daisuke Kurita, Ritsuko Seki, Kensaku Sato, Yuya Sasaki, Koichi Ohshima, Keisuke Kawamoto, Joji Shimono, Ayako Ichikawa, Michihide Tokuhira, Masahiro Kizaki, Yoshitaka Imaizumi, Jun-ichi Tamaru, Koji Nagafuji, Kyohei Yamada, Reiji Muto |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Herpesvirus 4 Human Time Factors Lymphoproliferative disorders Arthritis Opportunistic Infections Gastroenterology Risk Assessment Lymphoid hyperplasia Drug Administration Schedule Pathology and Forensic Medicine Arthritis Rheumatoid 03 medical and health sciences Immunocompromised Host 0302 clinical medicine International Prognostic Index immune system diseases Risk Factors hemic and lymphatic diseases Internal medicine medicine Humans Progression-free survival Aged 030203 arthritis & rheumatology Aged 80 and over Univariate analysis business.industry Middle Aged medicine.disease Lymphoproliferative Disorders Progression-Free Survival Methotrexate 030220 oncology & carcinogenesis Rheumatoid arthritis Antirheumatic Agents Disease Progression RNA Viral Surgery Female Anatomy medicine.symptom business medicine.drug |
| Zdroj: | The American journal of surgical pathology. 43(7) |
| ISSN: | 1532-0979 |
| Popis: | Methotrexate (MTX) carries a risk of lymphoproliferative disorders (LPDs), but MTX-associated LPDs (MTX-LPDs) can resolve spontaneously after MTX withdrawal. However, the precise clinicopathologic features of MTX-LPD remain unclear. We aimed to investigate the clinicopathologic characteristics, outcomes, and prognostic factors for histologic types of MTX-LPD. Paraffin-embedded tissue samples of 219 patients with MTX-LPD were analyzed. In total, 30,33,106, and 26 had reactive lymphoid hyperplasia (RH), polymorphic-LPD (Poly-LPD), diffuse large B-cell lymphomas (DLBCLs), and classic Hodgkin lymphoma (CHL), respectively. The clinicopathologic features of RH, Poly-LPD, DLBCLs, and CHL were as follows: extranodal involvement: 13.8% (4/29), 36.4% (12/33), 69.5% (73/105), and 15.4% (4/26); Epstein-Barr virus encoded RNA positivity: 55.2% (16/29), 71.9% (23/32), 45.3% (48/106), and 76.9% (20/26); necrosis: 0% (0/29), 51.5% (17/33), 34.3% (36/105), and 12.0% (3/25); and Hodgkin Reed-Sternberg-like cells: 17.2% (5/29), 50% (14/28), and 19.8% (21/106). The median duration from MTX withdrawal to the time of disease regression was 10.4, 3.0, 4.2, and 2.7 months for RH, Poly-LPD, DLBCLs, and CHL. After MTX withdrawal, progression-free survival was the greatest for RH, followed by for Poly-LPD, DLBCL, and CHL (all P |
| Databáze: | OpenAIRE |
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