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[Methotrexate-associated lymphoproliferative disorders: clinical aspects].
Michihide Tokuhira1, Masahiro Kizaki1
1Saitama Medical Center, Saitama Medical University.
[Rinsho Ketsueki] the Japanese Journal of Clinical Hematology
|September 6, 2019
Summary
Methotrexate-associated lymphoproliferative disorders (MTX-LPD) can occur in patients with autoimmune diseases on methotrexate. While many cases of MTX-LPD regress after stopping methotrexate, outcomes vary by subtype and patient factors.
Area of Science:
- Immunology
- Oncology
- Pharmacology
Background:
- Methotrexate-associated lymphoproliferative disorders (MTX-LPD) are iatrogenic conditions arising in patients with autoimmune diseases (AIDs) treated with methotrexate (MTX).
- MTX-LPD exhibits diverse subtypes with variable regression rates, relapse potential, and prognoses.
- Japanese patients show a higher incidence of MTX-LPD.
Purpose of the Study:
- To summarize the characteristics of MTX-LPD.
- To highlight the influence of absolute lymphocyte count (ALC) on MTX-LPD.
- To emphasize the need for careful assessment of MTX-LPD.
Main Methods:
- Literature review of MTX-LPD cases.
- Analysis of clinical features, including regression and relapse rates.
- Investigation of potential influencing factors like ALC.
Main Results:
- Approximately two-thirds of MTX-LPD cases regress upon MTX withdrawal.
- Significant variability exists in the clinical behavior and prognosis of different MTX-LPD subtypes.
- Peripheral blood absolute lymphocyte count (ALC) may play a role in LPD development and regression.
Conclusions:
- MTX-LPD is a heterogeneous group of disorders requiring careful clinical evaluation.
- Understanding factors influencing MTX-LPD pathogenesis and clinical course is crucial.
- MTX withdrawal is a key management strategy, though outcomes vary.
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