title: Clinicopathological analyses in patients with other iatrogenic immunodeficiency-associated lymphoproliferative diseases and rheumatoid arthritis.
abstract: Despite numerous attempts to uncover the mechanism of other iatrogenic immunodeficiency-associated lymphoproliferative diseases (OIIA-LPDs), this mechanism remains poorly understood, especially in rheumatoid arthritis (RA) patients. We analyzed the data on 23 patients with LPDs and RA. Patients were categorized into three groups according to whether they had methotrexate (MTX); MTX-regressive LPDs, MTX-persistent LPDs or other drugs-mediated LPDs. The LPDs seen in OIIA-LPDs-RA might have a unique behavior to think about several rare phenotypes. The overall survival of all patients was 74% at 5 years, and those of the three groups were 100%, 64% and 60%, respectively. Among the 6 patients who died, 4 had LPDs that were detected late, and thus adequate treatment was not given. In addition, several patients with diffuse large B cell lymphoma with a complex karyotype achieved complete remission (CR). Only one among the 17 patients who achieved CR relapsed. OIIA-LPDs-RA appeared to have a better prognosis than other more common types of lymphomas. Regarding RA treatment, various anti-RA drugs were given to the patients after developing LPDs, including MTX, but no recurrent patients were documented.
authors.affiliation: Department of Hematology, Saitama Medical Center, Saitama Medical University, Kawagoe, Saitama, Japan. tokuhira@saitama-med.ac.jp
authors.forename: Michihide
authors.initials: M
authors.lastname: Tokuhira
authors.forename: Reiko
authors.initials: R
authors.lastname: Watanabe
authors.forename: Tomoe
authors.initials: T
authors.lastname: Nemoto
authors.forename: Morihiko
authors.initials: M
authors.lastname: Sagawa
authors.forename: Tatsuki
authors.initials: T
authors.lastname: Tomikawa
authors.forename: Jun-ichi
authors.initials: J
authors.lastname: Tamaru
authors.forename: Shinji
authors.initials: S
authors.lastname: Itoyama
authors.forename: Hayato
authors.initials: H
authors.lastname: Nagasawa
authors.forename: Koichi
authors.initials: K
authors.lastname: Amano
authors.forename: Hideto
authors.initials: H
authors.lastname: Kameda
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Takeuchi
authors.forename: Shigehisa
authors.initials: S
authors.lastname: Mori
authors.forename: Masahiro
authors.initials: M
authors.lastname: Kizaki
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018951:Antigens, CD20 / Q000378:metabolism; D018501:Antirheumatic Agents / Q000009:adverse effects / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D002869:Chromosome Aberrations; D020031:Epstein-Barr Virus Infections / Q000473:pathology / Q000821:virology; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D016867:Immunocompromised Host; D007150:Immunohistochemistry; D059785:Karyotype; D017730:Ki-1 Antigen / Q000378:metabolism; D008232:Lymphoproliferative Disorders / Q000139:chemically induced / Q000473:pathology* / Q000628:therapy; D008297:Male; D008727:Methotrexate / Q000009:adverse effects / Q000627:therapeutic use*; D008875:Middle Aged; D011379:Prognosis; D016019:Survival Analysis
chemical_list: D018951:Antigens, CD20; D018501:Antirheumatic Agents; D017730:Ki-1 Antigen; D008727:Methotrexate