Joseph Ranjit, Bockorny Bruno, Dasanu Constantin A
Department of Medicine, University of Connecticut Health Center, Farmington, CT, USA.
J Oncol Pharm Pract. 2014 Apr;20(2):149-53. doi: 10.1177/1078155213484787. Epub 2013 May 15.
Methotrexate therapy has been associated with occurrence and/or accelerated progression of malignancies. We describe a patient who developed widespread bone metastases of a previously confined to the prostate gland prostate cancer shortly after starting methotrexate therapy for rheumatoid arthritis and large granular lymphocyte leukemia. We believe an immunosuppressive milieu brought on by the methotrexate use in this case is responsible for the rapid progression of prostate cancer leading to the patient's demise. To the best of our knowledge, no association has been made to date between the therapy with methotrexate and a fulminant course of a previously indolent prostate cancer. Given its utilization in a variety of benign and malignant conditions and the ageing population, caution is advised with the use of this agent, especially in the presence of an underlying malignancy.
甲氨蝶呤治疗与恶性肿瘤的发生和/或加速进展有关。我们描述了一名患者，在开始针对类风湿性关节炎和大颗粒淋巴细胞白血病进行甲氨蝶呤治疗后不久，其先前局限于前列腺的前列腺癌发生了广泛的骨转移。我们认为，该病例中使用甲氨蝶呤所导致的免疫抑制环境是前列腺癌快速进展并导致患者死亡的原因。据我们所知，迄今为止，甲氨蝶呤治疗与先前惰性前列腺癌的暴发性病程之间尚无关联。鉴于其在各种良性和恶性疾病中的应用以及人口老龄化，建议谨慎使用该药物，尤其是在存在潜在恶性肿瘤的情况下。
