Therapy-related lymphomas in patients with autoimmune diseases after treatment with disease-modifying anti-rheumatic drugs

被引：28
作者：
Au, WY
Ma, ESK
Choy, C
Chung, LP
Fung, TK
Liang, R
Kwong, YL
机构：
[1] Univ Hong Kong, Queen Mary Hosp, Dept Med, Hong Kong, Hong Kong, Peoples R China
[2] Univ Hong Kong, Queen Mary Hosp, Dept Pathol, Hong Kong, Hong Kong, Peoples R China
来源：
AMERICAN JOURNAL OF HEMATOLOGY | 2006年 / 81卷 / 01期
关键词：
therapy-related lymphoma; autoimmune diseases; methotrexate; azathioprine; cyclophosphamide;
D O I：
10.1002/ajh.20508
中图分类号：
R5 [内科学];
学科分类号：
1002 ; 100201 ;
摘要：
Ten patients developing lymphomas after disease modifying anti-rheumatic drugs (DMARD) (methotrexate, n = 3, mean cumulative dose = 3.4 g; cyclophosphamide, n = 2, mean dose = 70 g; azathioprine, n = 6, mean dose = 243 g) were investigated. Methotrexate-related lymphomas were Epstein-Barr virus (EBV)-positive, had infrequent aberrant methylation of p15 and p16, and responded well to methotrexate withdrawal or anti-CD20 antibody (rituximab) alone without concomitant chemotherapy, implying that defective immunosurveillance was important in lymphomagenesis. However, 75% of cyclophosphamide/azathioprine-related lymphomas were EBV-negative, had frequent p15 and p16 methylation, and responded poorly to drug withdrawal and chemotherapy, implying that direct drug-induced mutagenesis might be involved in lymphomagenesis.
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页码：5 / 11
页数：7
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