Ureshino Hiroshi, Kadota Chiho, Kurogi Kazuya, Miyahara Masaharu, Kimura Shinya
Department of Internal Medicine, Karatsu Red Cross Hospital, Japan.
Intern Med. 2015;54(17):2235-9. doi: 10.2169/internalmedicine.54.4207. Epub 2015 Sep 1.
Spontaneous regression of methotrexate-related lymphoproliferative disorders (MTX-LPDs) occurs in some patients after withdrawal of MTX. However, the mechanisms by which MTX withdrawal contributes to the spontaneous regression of MTX-LPDs have not been fully elucidated. We herein show that spontaneous regression of MTX-LPDs is associated with the development of significant and transient T-cell large granular lymphocyte (T-LGL) lymphocytosis induced by MTX withdrawal. Since T-LGLs show strong cytotoxicity, their expansion may contribute to the spontaneous regression of lymphoma. Therefore, the development of T-LGL lymphocytosis maybe associated with a favorable prognosis in MTX-LPD patients.
在停用甲氨蝶呤（MTX）后，部分甲氨蝶呤相关淋巴增殖性疾病（MTX-LPDs）患者会出现自发缓解。然而，停用MTX促使MTX-LPDs自发缓解的机制尚未完全阐明。我们在此表明，MTX-LPDs的自发缓解与停用MTX诱导的显著且短暂的T细胞大颗粒淋巴细胞（T-LGL）淋巴细胞增多症的发生有关。由于T-LGL具有强大的细胞毒性，其扩增可能有助于淋巴瘤的自发缓解。因此，T-LGL淋巴细胞增多症的发生可能与MTX-LPD患者的良好预后相关。
