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https://www.readbyqxmd.com/read/28877615/clinicopathologic-investigation-of-methotrexate-induced-lymphoproliferative-disorders-with-a-focus-on-regression
#1
Michihide Tokuhira, Shuntaro Saito, Ayumi Okuyama, Katsuya Suzuki, Morihiro Higashi, Shuji Momose, Takayuki Shimizu, Takehiko Mori, Tomoe Anan-Nemoto, Koichi Amano, Shinichiro Okamoto, Tsutomu Takeuchi, Jun-Ichi Tamaru, Masahiro Kizaki
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...
September 7, 2017: Leukemia & Lymphoma
https://www.readbyqxmd.com/read/28758827/lymphoproliferative-disorders-in-patients-with-rheumatoid-arthritis-in-the-era-of-widespread-use-of-methotrexate-a-review-of-the-literature-and-current-perspective
#2
Masayoshi Harigai
Lymphoproliferative disorders (LPD) in patients receiving methotrexate (MTX) have gained strong attention. In this article, I reviewed the basic and clinical findings of this issue. Patients with RA possess a high risk of lymphoma, but epidemiological evidence showing an association between the use of MTX and lymphoma is still limited. Rapid regression of LPD after stopping MTX in patients with RA strongly suggests that there is a causative relationship. Genetic predisposition, accumulated inflammation, impaired generation of Epstein-Barr virus (EBV)-specific cytotoxic T lymphocytes, effects of MTX on the regulation of EBV genes, and low hypermethylation of apoptosis-related genes are relevant to the development of LPD and rapid regression after cessation of MTX...
July 31, 2017: Modern Rheumatology
https://www.readbyqxmd.com/read/28747604/methotrexate-associated-lymphoproliferative-disorder
#3
Yuko Kaneko
  Methotrexate-associated lymphproliferative disorder (MTX-LPD) is a rare but critical complication developing in patients treated with methotrexate. Now that methotrexate is an anchor drug in the management of rheumatoid arthritis and become commonly used, MTX-LPD cases have increased. Many things has been unclear such as incidence, demographic characters, and risk factors. However, as the researches increased, several interesting topics has been demonstrated like associations with Epsteiin-Barr virus and with cell-mediated immunity...
2017: Nihon Rinshō Men'eki Gakkai Kaishi, Japanese Journal of Clinical Immunology
https://www.readbyqxmd.com/read/28679993/iatrogenic-immunodeficiency-associated-epstein-barr-virus-ebv-negative-natural-killer-cell-lymphoproliferative-disorder-in-a-patient-undergoing-rheumatoid-arthritis-therapy
#4
Tomoyuki Uchida, Morihiro Inoue, Jian Hua, Shogo Tajima, Yasunori Ota, Masao Hagihara
Here we present a patient with rheumatoid arthritis (RA), who was suspected to have developed malignant lymphoma during immunosuppressive therapy 5 years earlier. She temporarily achieved remission after discontinuing therapy; however, her disease worsened with remittent fever and splenomegaly. Splenic biopsy demonstrated infiltration by abnormal cells, which were positive for CD56 and T cell intracytoplasmic antigen, but negative for CD3 and Epstein-Barr virus (EBV) -encoded RNA. Cytogenetic analysis of bone marrow and lumbar spine tumor revealed common complex karyotype abnormalities...
2017: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology
https://www.readbyqxmd.com/read/28676912/clinical-characteristics-of-methotrexate-associated-lymphoproliferative-disorders-relationship-between-absolute-lymphocyte-count-recovery-and-spontaneous-regression
#5
Satoshi Takanashi, Yoshinobu Aisa, Chisako Ito, Hideki Arakaki, Yuki Osada, Yuichiro Amano, Motoharu Hirano, Tomonori Nakazato
Several reports have shown that patients with rheumatoid arthritis (RA) are at increased risk of developing lymphoproliferative disorders (LPD). Methotrexate (MTX) has been recognized as a major cause of LPD. Sometimes spontaneous regression (SR) occurs after withdrawal of MTX. Recent studies suggest that the early recovery of the absolute lymphocyte count (ALC) after withdrawal of MTX is associated with the spontaneous regression of MTX-LPD. We retrospectively analyzed 26 patients with MTX-LPD to identify predictive factors for spontaneous regression...
July 5, 2017: Rheumatology International
https://www.readbyqxmd.com/read/28654766/methotrexate-related-lymphoproliferative-disorder-in-patients-with-osteonecrosis-of-the-jaw-a-3-case-report-and-literature-review
#6
Ken Furudate, Anna Satake, Norihiko Narita, Wataru Kobayashi
Patients with immunodeficiency or immunosuppression are at risk of developing a lymphoproliferative disorder (LPD). Methotrexate (MTX) is an iatrogenic cause of LPD, which in up to 50% cases occurs in extranodal sites. The occurrence of MTX-related LPD with osteonecrosis of the jaw (ONJ) has rarely been reported. Moreover, there are no clear diagnostic criteria and treatment strategies for management of these lesions. In the present cases, discontinuing MTX and debridement of the necrotic bone were effective...
June 1, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28455827/characteristics-and-risk-factors-of-lymphoproliferative-disorders-among-patients-with-rheumatoid-arthritis-concurrently-treated-with-methotrexate-a-nested-case-control-study-of-the-iorra-cohort
#7
Yoko Shimizu, Ayako Nakajima, Eisuke Inoue, Kumi Shidara, Naoki Sugimoto, Yohei Seto, Eiichi Tanaka, Shigeki Momohara, Atsuo Taniguchi, Hisashi Yamanaka
The purpose of the study is to demonstrate the characteristics of lymphoproliferative disorders (LPDs) in patients with rheumatoid arthritis (RA) and risk factors for LPD among RA patients concurrently treated with methotrexate (MTX). Among patients who participated in the Institute of Rheumatology, Rheumatoid Arthritis (IORRA) cohort study in October 2010, past existence of LPD from patient's report was confirmed through medical charts. Background factors, LPD pathological findings, and the clinical courses of LPD and RA after LPD were assessed...
June 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/28380678/clinicopathological-analysis-of-methotrexate-associated-lymphoproliferative-disorders-comparison-of-diffuse-large-b-cell-lymphoma-and-classical-hodgkin-lymphoma-types
#8
Yuka Gion, Noriko Iwaki, Katsuyoshi Takata, Mai Takeuchi, Keiichiro Nishida, Yorihisa Orita, Tomoyasu Tachibana, Tadashi Yoshino, Yasuharu Sato
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])...
June 2017: Cancer Science
https://www.readbyqxmd.com/read/28331131/the-aggressive-clinical-courses-of-hodgkin-lymphoma-primarily-diagnosed-as-methotrexate-induced-non-specific-lymphoproliferative-disorder-in-patients-with-rheumatoid-arthritis
#9
Michihide Tokuhira, Takayuki Tabayashi, Yuka Tanaka, Yasuyuki Takahashi, Yuta Kimura, Tatsuki Tomikawa, Tomoe Anan-Nemoto, Shuju Momose, Morihiro Higashi, Ayumi Okuyama, Reiko Watanabe, Koichi Amano, Jun-Ichi Tamaru, Masahiro Kizaki
Recently, attention has been focused on methotrexate-induced lymphoproliferative disease (MTX-LPD), and atypical phenotypes are occasionally documented. We encountered two patients with rheumatoid arthritis (RA) who were diagnosed with non-specific LPD (LPD-nos). Biopsy samples were not obtained during the initial examination when the LPD development was discovered, and the patients achieved a complete response after MTX cessation (case 1) or steroid pulse therapy (case 2). However, the tumors flared up 1.5 years later, and LPD-nos was determined following biopsies of the lymph node (LN, case 1) and liver (case 2)...
2017: Journal of Clinical and Experimental Hematopathology: JCEH
https://www.readbyqxmd.com/read/28199343/long-term-treatment-with-abatacept-or-tocilizumab-does-not-increase-epstein-barr-virus-load-in-patients-with-rheumatoid-arthritis-a-three-years-retrospective-study
#10
Nathalie Balandraud, Gaetan Texier, Emmanuel Massy, Olivier Muis-Pistor, Marielle Martin, Isabelle Auger, Marie-Caroline Guzian, Sandrine Guis, Thao Pham, Jean Roudier
BACKGROUND: Epstein-Barr Virus (EBV) is a widely disseminated lymphotropic herpes virus implicated in benign and malignant disorders. In transplant patients, immunosuppressive drugs (cyclosporine) diminish control of EBV replication, potentially leading to lymphoproliferative disorders (LPD). Rheumatoid arthritis (RA) patients have impaired control of EBV infection and have EBV load ten times higher than controls. As post transplant patients, patients with RA have increased risk of developing lymphomas...
2017: PloS One
https://www.readbyqxmd.com/read/27846761/prognostic-factors-of-methotrexate-associated-lymphoproliferative-disorders-associated-with-rheumatoid-arthritis-and-plausible-application-of-biological-agents
#11
Takayuki Katsuyama, Ken-Ei Sada, Minglu Yan, Sonia Zeggar, Sumie Hiramatsu, Yoshia Miyawaki, Keiji Ohashi, Michiko Morishita, Haruki Watanabe, Eri Katsuyama, Mariko Takano-Narazaki, Noriko Toyota-Tatebe, Katsue Sunahori-Watanabe, Tomoko Kawabata, Kohei Miyake, Toru Kiguchi, Jun Wada
OBJECTIVES: To determine prognostic factors of methotrexate-associated lymphoproliferative disorder (MTX-LPD) and evaluate the efficacy and safety of biological therapy in rheumatoid arthritis (RA) complicated with MTX-LPD. METHODS: Thirty RA patients who developed MTX-LPD were investigated in this study. We compared the clinical and laboratory parameters of patients who achieved regression of LPD by MTX withdrawal with those who required chemotherapy and evaluated the clinical course of RA after LPD development...
December 15, 2016: Modern Rheumatology
https://www.readbyqxmd.com/read/27577564/a-case-of-multiple-hepatic-lesions-associated-with-methotrexate-associated-lymphoproliferative-disorder
#12
Ruby Matsumoto, Kazushi Numata, Nobutaka Doba, Koji Hara, Makoto Chuma, Hiroyuki Fukuda, Akito Nozaki, Katsuaki Tanaka, Yoshimi Ishii, Shin Maeda
Patients receiving methotrexate (MTX) for the treatment of autoimmune disease are at a high risk of developing lymphoproliferative disorders (LPD), the so-called methotrexate-associated lymphoproliferative disorders (MTX-LPD). We recently performed abdominal ultrasonography (US) in a patient with rheumatoid arthritis (RA) who had developed hepatic dysfunction during the course of MTX therapy; the examination revealed multiple well-demarcated hepatic tumors with slightly irregular borders, the largest one measuring 9 cm in diameter...
October 2016: Journal of Medical Ultrasonics
https://www.readbyqxmd.com/read/27528380/the-usefulness-of-18-f-fdg-pet-ct-for-assessing-methotrexate-associated-lymphoproliferative-disorder-mtx-lpd
#13
Shiro Watanabe, Osamu Manabe, Kenji Hirata, Noriko Oyama-Manabe, Naoya Hattori, Yasuka Kikuchi, Kentaro Kobayashi, Takuya Toyonaga, Nagara Tamaki
BACKGROUND: Methotrexate-associated lymphoproliferative disorder (MTX-LPD) is a benign lymphoid proliferation or malignant lymphoma in patients who have been treated with MTX. MTX withdrawal and observation for a short period should be considered in the initial management of patients who develop LPD while on MTX therapy. Here we evaluated the diagnostic accuracy and predictive value of (18)F-fluorodeoxyglucose positron emission tomography/computed tomography ((18)F-FDG PET/CT) for MTX-LPD...
2016: BMC Cancer
https://www.readbyqxmd.com/read/27523005/other-iatrogenic-immunodeficiency-associated-lymphoproliferative-disorder-presenting-as-primary-bone-lymphoma-in-a-patient-with-rheumatoid-arthritis
#14
Kazuya Ishiguro, Toshiaki Hayashi, Yuka Aoki, Rieko Murakami, Hiroshi Ikeda, Tadao Ishida
Primary bone lymphoma (PBL) is a rare disorder. We herein present a case of other iatrogenic immunodeficiency-associated lymphoproliferative disorder (OIIA-LPD) presenting as PBL. A 63-year-old woman was diagnosed with rheumatoid arthritis and had been treated with methotrexate for seven years. Two months before admission, she suffered from pain in the limbs. Magnetic resonance imaging revealed multiple irregular lesions in the bones of the limbs, which showed an uptake of (18)F-FDG on positron emission tomography...
2016: Internal Medicine
https://www.readbyqxmd.com/read/27459820/-four-cases-of-other-iatrogenic-immunodeficiency-associated-lymphoproliferative-disorders-in-the-head-and-neck-region
#15
REVIEW
Masahiko Fukasawa, Yoshihiro Akazawa, Shigeru Kasugai, Koshi Mikami, Yoshimitsu Saito, Masatoshi Akutsu, Aibi Akashi, Kojiro Ido, Ichiro Maeda, Masahiro Hoshikawa, Izumi Koizuka
Other iatrogenic immunodeficiency-associated lymphoproliferative disorders (OIIA-LPD) comprise lymphoid proliferations or lymphomas that arise in patients treated with immunosuppressive drugs for autoimmune diseases, especially rheumatoid arthritis (RA) treated with methotrexate (MTX). MTX has been increasingly administered to patients with RA, resulting in methotrexate-associated lymphoproliferative disorder (MTX-LPD) in patients. We report herein on four cases of patients with RA, who diagnosed with head and neck region...
May 2016: Nihon Jibiinkoka Gakkai Kaiho
https://www.readbyqxmd.com/read/27335685/methotrexate-associated-primary-cutaneous-cd30-positive-cutaneous-t-cell-lymphoproliferative-disorder-a-case-illustration-and-a-brief-review
#16
Wederson M Claudino, Bradley Gibson, William Tse, Maxwell Krem, Jaspreet Grewal
Methotrexate (MTX) is a commonly used anti-metabolite agent. Increased risk of lymphoproliferative disorders (LPD) in patients with rheumatoid arthritis (RA) has been documented with the prolonged use of immunosuppressive medications such as MTX. This is thought to be the result of immune dysregulation and/or chronic immune stimulation. Most cases of LPDs regress following withdrawal of the offending immunosuppressive agent. We present an interesting and rare case of CD30 and EBV positive CD8 primary cutaneous anaplastic large cell lymphoma (PC-ALCL) in a 66-year-old African American woman...
2016: American Journal of Blood Research
https://www.readbyqxmd.com/read/27311195/-rheumatoid-arthritis-and-malignancy
#17
REVIEW
Tomohiro Kameda, Hiroaki Dobashi
Rheumatoid arthritis (RA) is associated with excess mortality. Especially, malignancy is a major cause of mortality. According to previous reports, the overall incidence of malignancies in RA patients has been reported to be comparable or slightly higher than that in general population. The increased incidence of malignant lymphoma and lung cancer has been reported to be consistent in most studies. The use of some csDMARD was also reported as risk factors for malignancy. Recently, MTX associated lymphoproliferative disorder(MTX-LPD) is one of the important complications in RA treatment...
June 2016: Nihon Rinsho. Japanese Journal of Clinical Medicine
https://www.readbyqxmd.com/read/27018050/methotrexate-associated-orbital-lymphoproliferative-disorder-in-a-patient-with-rheumatoid-arthritis-a-case-report
#18
Yuka Kobayashi, Kazuhiro Kimura, Youichiro Fujitsu, Kuniisa Shinkawa, Hiroko Muta, Koh-Hei Sonoda
PURPOSE: Lymphoproliferative disorders (LPDs) can develop in patients treated with methotrexate (MTX) and usually respond well to MTX withdrawal. Mucosa-associated lymphoid tissue (MALT) lymphoma is a relatively rare type of MTX-LPD. The development of MTX-LPD in the orbit has not been previously described. We here report a case of orbital MALT lymphoma that disappeared after MTX withdrawal in a patient treated with MTX for rheumatoid arthritis. CASE: A 78-year-old woman who complained of swelling of the left upper eyelid had been treated with MTX for >8 years for rheumatoid arthritis...
May 2016: Japanese Journal of Ophthalmology
https://www.readbyqxmd.com/read/26861097/-immunodeficiency-associated-burkitt-lymphoma-developed-in-a-patient-receiving-a-long-term-methotrexate-therapy-for-rheumatoid-arthritis
#19
Takefumi Katsuragi, Atsushi Iwashige, Junichi Tsukada
An increased risk of lymphoproliferative disorders (LPD) has been demonstrated in patients treated with methotrexate (MTX) for rheumatoid arthritis (RA). The role of Epstein-Barr virus (EBV) has been discussed in the pathogenesis of immunodeficiency-associated LPDs. We herein present a RA patient, who developed Burkitt lymphoma during MTX treatment. The patient was a 61-year-old Japanese female with a 10-year history of weekly MTX therapy for RA. She presented with a one-month history of submandibular lymph node swelling and fever...
January 2016: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology
https://www.readbyqxmd.com/read/26733461/methotrexate-related-lymphoproliferative-disorder-of-the-stomach-in-a-patient-with-rheumatoid-arthritis-a-case-of-disease-regression-after-methotrexate-cessation
#20
Kazuki Ikeda, Takefumi Nakamura, Takahiro Kinoshita, Mikio Fujiwara, Suguru Uose, Hitoshi Someda, Takashi Miyoshi, Katsuhiro Io, Ken-Ichi Nagai
We report the case of a 78-year-old woman with methotrexate-related gastric lymphoproliferative disorder (LPD). The patient had a history of rheumatoid arthritis (RA) and had been treated with methotrexate (MTX). Endoscopic examination revealed round elevated lesions in the stomach, and a biopsy specimen showed atypical lymphoid cell proliferation. Immunohistological study found these atypical cells to be positive for L-26 but not for CD3 or EBER. Therefore, we made a diagnosis of MTX-related LPD showing features of diffuse large B-cell lymphoma...
February 2016: Clinical Journal of Gastroenterology
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