Document Detail


Lymphoma in patients with rheumatoid arthritis: association with the disease state or methotrexate treatment.
MedLine Citation:
PMID:  9213378     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Although long-term clinical studies have shown no excessive risk of lymphoma in rheumatoid arthritis (RA) patients treated with methotrexate (MTX), an increasing number of reports of this association continue to appear. We describe two cases, review the cases in the world's literature, and summarize their important characteristics. Possible oncogenic mechanisms are discussed. Most lymphoproliferation cases presented here have features of immunosuppression-associated lymphoma. The immunosuppressed state is attributable to a combination of factors, such as RA itself and the actions of MTX. The risk factors for RA patients to develop lymphoma while on MTX include severe disease, intense immunosuppression, genetic predisposition, and an increased frequency of latent infection with prooncogenic viruses such as Epstein-Barr virus (EBV). The spontaneous remission of lymphomas in eight RA patients after MTX was stopped highlights the likely causative role of the drug in the development of these malignancies. If the clinical situation permits, a period of observation for spontaneous remission after MTX is stopped is advisable. The physicians caring for RA patients on MTX should maintain a high surveillance for signs and symptoms suggestive of lymphoma.
Authors:
L Georgescu; G C Quinn; S Schwartzman; S A Paget
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Publication Detail:
Type:  Case Reports; Journal Article; Review    
Journal Detail:
Title:  Seminars in arthritis and rheumatism     Volume:  26     ISSN:  0049-0172     ISO Abbreviation:  Semin. Arthritis Rheum.     Publication Date:  1997 Jun 
Date Detail:
Created Date:  1997-08-21     Completed Date:  1997-08-21     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  1306053     Medline TA:  Semin Arthritis Rheum     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  794-804     Citation Subset:  IM    
Affiliation:
Department of Medicine, New York Hospital-Cornell University Medical Center, New York 10021, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Antirheumatic Agents / adverse effects*,  therapeutic use
Arthritis, Rheumatoid / complications,  drug therapy*
Female
Humans
Lymphoma, Non-Hodgkin / chemically induced*,  complications
Methotrexate / adverse effects*,  therapeutic use
Middle Aged
Risk Factors
Chemical
Reg. No./Substance:
0/Antirheumatic Agents; 59-05-2/Methotrexate
Comments/Corrections
Comment In:
Semin Arthritis Rheum. 1997 Jun;26(6):785-7   [PMID:  9213376 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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