Department of Hematology, Saitama Medical Center, Saitama Medical University, Kawagoe, Saitama, Japan.
Leuk Lymphoma. 2012 Apr;53(4):616-23. doi: 10.3109/10428194.2011.625101. Epub 2011 Nov 25.
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.
尽管人们已经尝试了多种方法来揭示其他医源性免疫缺陷相关淋巴增生性疾病（OIIA-LPD）的发病机制，但该机制仍未得到充分理解，尤其是在类风湿关节炎（RA）患者中。我们分析了 23 例 LPD 合并 RA 患者的数据。根据患者是否使用甲氨蝶呤（MTX），将其分为三组：MTX 诱导消退的 LPD、MTX 持续存在的 LPD 或其他药物介导的 LPD。OIIA-LPD 合并 RA 中的 LPD 可能具有独特的行为，需要考虑几种罕见的表型。所有患者的 5 年总生存率为 74%，三组分别为 100%、64%和 60%。在 6 例死亡患者中，4 例 LPD 发现较晚，因此未给予充分治疗。此外，几名患有复杂核型弥漫性大 B 细胞淋巴瘤的患者达到完全缓解（CR）。在 17 例达到 CR 的患者中，仅有 1 例复发。OIIA-LPD 合并 RA 的预后似乎优于其他更常见类型的淋巴瘤。关于 RA 的治疗，在发生 LPD 后，患者接受了包括 MTX 在内的各种抗 RA 药物治疗，但未发现复发病例。
