Cargando…
Clinicopathological evaluation of methotrexate-associated lymphoproliferative disorders with special focus on Epstein-Barr virus-positive mucocutaneous lesions
Some patients diagnosed with methotrexate-associated lymphoproliferative disorder (MTX-LPD) develop spontaneous regression upon the discontinuation of MTX, whereas others require chemotherapy. The mechanisms underlying this differential response and the capacity to spontaneously regress are not clea...
Autores principales: | , , , , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Japanese Society for Lymphoreticular Tissue Research
2020
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7810250/ https://www.ncbi.nlm.nih.gov/pubmed/33148934 http://dx.doi.org/10.3960/jslrt.20041 |
_version_ | 1783637276574613504 |
---|---|
author | Shiraiwa, Sawako Kikuti, Yara Yukie Carreras, Joaquim Hara, Ryujiro Aoyama, Yasuyuki Ogiya, Daisuke Suzuki, Rikio Toyosaki, Masako Ohmachi, Ken Ogawa, Yoshiaki Kawada, Hiroshi Sato, Shinji Nakamura, Naoya Ando, Kiyoshi |
author_facet | Shiraiwa, Sawako Kikuti, Yara Yukie Carreras, Joaquim Hara, Ryujiro Aoyama, Yasuyuki Ogiya, Daisuke Suzuki, Rikio Toyosaki, Masako Ohmachi, Ken Ogawa, Yoshiaki Kawada, Hiroshi Sato, Shinji Nakamura, Naoya Ando, Kiyoshi |
author_sort | Shiraiwa, Sawako |
collection | PubMed |
description | Some patients diagnosed with methotrexate-associated lymphoproliferative disorder (MTX-LPD) develop spontaneous regression upon the discontinuation of MTX, whereas others require chemotherapy. The mechanisms underlying this differential response and the capacity to spontaneously regress are not clearly understood. We evaluated numerous clinicopathological features in 63 patients diagnosed with MTX-LPD, with a special focus on those with Epstein-Barr virus (EBV)-positive mucocutaneous lesions (EBVMCL). The diagnosis of EBVMCL included cases of both EBV-positive mucocutaneous ulcers (EBVMCU) and diffuse gingival swelling associated with proliferation of EBV-positive large B-cells. Of the four subgroups of MTX-LPD, one-year treatment-free survival (TFS) after the discontinuation of MTX was achieved among those with EBVMCL (100%), diffuse large B-cell lymphoma (57%), Hodgkin-like lesions (60%), or classical Hodgkin lymphoma (29%); a significant difference in TFS was observed when comparing the responses of patients with EBVMCL to the those diagnosed with other subtypes. Multivariate analysis revealed predictive factors for prolonged TFS that included EBV-positive lesions and comparatively low levels of serum LDH. Taken together, our study suggests that a diagnosis of EBVMCL is related to the overall clinical outcome after the discontinuation of MTX. |
format | Online Article Text |
id | pubmed-7810250 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Japanese Society for Lymphoreticular Tissue Research |
record_format | MEDLINE/PubMed |
spelling | pubmed-78102502021-01-19 Clinicopathological evaluation of methotrexate-associated lymphoproliferative disorders with special focus on Epstein-Barr virus-positive mucocutaneous lesions Shiraiwa, Sawako Kikuti, Yara Yukie Carreras, Joaquim Hara, Ryujiro Aoyama, Yasuyuki Ogiya, Daisuke Suzuki, Rikio Toyosaki, Masako Ohmachi, Ken Ogawa, Yoshiaki Kawada, Hiroshi Sato, Shinji Nakamura, Naoya Ando, Kiyoshi J Clin Exp Hematop Original Article Some patients diagnosed with methotrexate-associated lymphoproliferative disorder (MTX-LPD) develop spontaneous regression upon the discontinuation of MTX, whereas others require chemotherapy. The mechanisms underlying this differential response and the capacity to spontaneously regress are not clearly understood. We evaluated numerous clinicopathological features in 63 patients diagnosed with MTX-LPD, with a special focus on those with Epstein-Barr virus (EBV)-positive mucocutaneous lesions (EBVMCL). The diagnosis of EBVMCL included cases of both EBV-positive mucocutaneous ulcers (EBVMCU) and diffuse gingival swelling associated with proliferation of EBV-positive large B-cells. Of the four subgroups of MTX-LPD, one-year treatment-free survival (TFS) after the discontinuation of MTX was achieved among those with EBVMCL (100%), diffuse large B-cell lymphoma (57%), Hodgkin-like lesions (60%), or classical Hodgkin lymphoma (29%); a significant difference in TFS was observed when comparing the responses of patients with EBVMCL to the those diagnosed with other subtypes. Multivariate analysis revealed predictive factors for prolonged TFS that included EBV-positive lesions and comparatively low levels of serum LDH. Taken together, our study suggests that a diagnosis of EBVMCL is related to the overall clinical outcome after the discontinuation of MTX. Japanese Society for Lymphoreticular Tissue Research 2020-11-04 /pmc/articles/PMC7810250/ /pubmed/33148934 http://dx.doi.org/10.3960/jslrt.20041 Text en © 2020 by The Japanese Society for Lymphoreticular Tissue Research https://creativecommons.org/licenses/by-nc-sa/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution ShareAlike (CC BY-NC-SA) 4.0 License. |
spellingShingle | Original Article Shiraiwa, Sawako Kikuti, Yara Yukie Carreras, Joaquim Hara, Ryujiro Aoyama, Yasuyuki Ogiya, Daisuke Suzuki, Rikio Toyosaki, Masako Ohmachi, Ken Ogawa, Yoshiaki Kawada, Hiroshi Sato, Shinji Nakamura, Naoya Ando, Kiyoshi Clinicopathological evaluation of methotrexate-associated lymphoproliferative disorders with special focus on Epstein-Barr virus-positive mucocutaneous lesions |
title | Clinicopathological evaluation of methotrexate-associated
lymphoproliferative disorders with special focus on Epstein-Barr virus-positive
mucocutaneous lesions |
title_full | Clinicopathological evaluation of methotrexate-associated
lymphoproliferative disorders with special focus on Epstein-Barr virus-positive
mucocutaneous lesions |
title_fullStr | Clinicopathological evaluation of methotrexate-associated
lymphoproliferative disorders with special focus on Epstein-Barr virus-positive
mucocutaneous lesions |
title_full_unstemmed | Clinicopathological evaluation of methotrexate-associated
lymphoproliferative disorders with special focus on Epstein-Barr virus-positive
mucocutaneous lesions |
title_short | Clinicopathological evaluation of methotrexate-associated
lymphoproliferative disorders with special focus on Epstein-Barr virus-positive
mucocutaneous lesions |
title_sort | clinicopathological evaluation of methotrexate-associated
lymphoproliferative disorders with special focus on epstein-barr virus-positive
mucocutaneous lesions |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7810250/ https://www.ncbi.nlm.nih.gov/pubmed/33148934 http://dx.doi.org/10.3960/jslrt.20041 |
work_keys_str_mv | AT shiraiwasawako clinicopathologicalevaluationofmethotrexateassociatedlymphoproliferativedisorderswithspecialfocusonepsteinbarrviruspositivemucocutaneouslesions AT kikutiyarayukie clinicopathologicalevaluationofmethotrexateassociatedlymphoproliferativedisorderswithspecialfocusonepsteinbarrviruspositivemucocutaneouslesions AT carrerasjoaquim clinicopathologicalevaluationofmethotrexateassociatedlymphoproliferativedisorderswithspecialfocusonepsteinbarrviruspositivemucocutaneouslesions AT hararyujiro clinicopathologicalevaluationofmethotrexateassociatedlymphoproliferativedisorderswithspecialfocusonepsteinbarrviruspositivemucocutaneouslesions AT aoyamayasuyuki clinicopathologicalevaluationofmethotrexateassociatedlymphoproliferativedisorderswithspecialfocusonepsteinbarrviruspositivemucocutaneouslesions AT ogiyadaisuke clinicopathologicalevaluationofmethotrexateassociatedlymphoproliferativedisorderswithspecialfocusonepsteinbarrviruspositivemucocutaneouslesions AT suzukirikio clinicopathologicalevaluationofmethotrexateassociatedlymphoproliferativedisorderswithspecialfocusonepsteinbarrviruspositivemucocutaneouslesions AT toyosakimasako clinicopathologicalevaluationofmethotrexateassociatedlymphoproliferativedisorderswithspecialfocusonepsteinbarrviruspositivemucocutaneouslesions AT ohmachiken clinicopathologicalevaluationofmethotrexateassociatedlymphoproliferativedisorderswithspecialfocusonepsteinbarrviruspositivemucocutaneouslesions AT ogawayoshiaki clinicopathologicalevaluationofmethotrexateassociatedlymphoproliferativedisorderswithspecialfocusonepsteinbarrviruspositivemucocutaneouslesions AT kawadahiroshi clinicopathologicalevaluationofmethotrexateassociatedlymphoproliferativedisorderswithspecialfocusonepsteinbarrviruspositivemucocutaneouslesions AT satoshinji clinicopathologicalevaluationofmethotrexateassociatedlymphoproliferativedisorderswithspecialfocusonepsteinbarrviruspositivemucocutaneouslesions AT nakamuranaoya clinicopathologicalevaluationofmethotrexateassociatedlymphoproliferativedisorderswithspecialfocusonepsteinbarrviruspositivemucocutaneouslesions AT andokiyoshi clinicopathologicalevaluationofmethotrexateassociatedlymphoproliferativedisorderswithspecialfocusonepsteinbarrviruspositivemucocutaneouslesions |