Tokuhira Michihide, Kizaki Masahiro
Saitama Medical Center, Saitama Medical University.
Rinsho Ketsueki. 2019;60(8):932-943. doi: 10.11406/rinketsu.60.932.
Methotrexate-associated lymphoproliferative disorders (MTX-LPD) is categorized into other iatrogenic immunodeficiency-associated lymphoproliferative disorders, developing LPD in patients with autoimmune diseases (AIDs) under low dose MTX administration. Two-thirds of MTX-LPDs regresses after MTX withdrawal with the higher incidence in Japanese patients, MTX-LPDs consist of various subtypes of LPDs, the feature of each LPD such as the regressive rate, relapse/regrowth rate, and prognosis, widely varies. The absolute lymphocyte count (ALC) in peripheral blood is suggested to influence LPD development, regression, and relapse/regrowth events. Because various factors might effect the pathogenesis and clinical features of MTX-LPD, careful attention should be paid to assess MTX-LPD.
甲氨蝶呤相关淋巴增殖性疾病（MTX-LPD）被归类为其他医源性免疫缺陷相关淋巴增殖性疾病，是在低剂量甲氨蝶呤给药下自身免疫性疾病（AIDs）患者发生的淋巴增殖性疾病。三分之二的MTX-LPD在停用甲氨蝶呤后会消退，在日本患者中发病率较高，MTX-LPD由各种淋巴增殖性疾病亚型组成，每种淋巴增殖性疾病的特征，如消退率、复发/再生长率和预后，差异很大。外周血绝对淋巴细胞计数（ALC）被认为会影响淋巴增殖性疾病的发生、消退以及复发/再生长情况。由于多种因素可能影响MTX-LPD的发病机制和临床特征，因此在评估MTX-LPD时应予以密切关注。
