Abstract | OBJECTIVES: METHODS: We evaluated the clinicopathological features, clinical characteristics, and treatment outcomes in 102 cases of RA-LPD. In addition, EBV infection and clonality of immunoglobulin heavy chain gene (IGH) were analyzed by in situ hybridization and polymerase chain reaction, respectively. RESULTS: The 102 cases included patients with diffuse large B-cell lymphoma (DLBCL; n = 53), Hodgkin lymphoma (n = 9), polymorphic B-cell LPD (n = 20), reactive lymphadenitis (n = 11), peripheral T-cell lymphoma (PTCL; n = 4), composite lymphoma (n = 2), and follicular lymphoma (n = 3). EBV was detected in 60% (56/93) of patients. Spontaneous regression occurred in 59% (28/47) of patients in whom MTX was withdrawn. Regression was associated with EBV positivity (P = 0.007) and non-DLBCL (P = 0.006), but not with MTX amount and other clinical features. Monoclonal bands of IGH were observed in 31 of 74 cases. In patients with DLBCL, poor disease-free survival (P = 0.05) was associated with clonality of IGH. In all patients, factors predictive of shorter survival were age (>70 yr) and histological type of DLBCL. CONCLUSIONS: Histology, EBV positivity, and monoclonality of IGH are useful for predicting clinical outcomes in patients with RA-LPD.
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Authors | Ayako Ichikawa, Fumiko Arakawa, Junichi Kiyasu, Kensaku Sato, Hiroaki Miyoshi, Daisuke Niino, Yoshizo Kimura, Masanori Takeuchi, Maki Yoshida, Yukinao Ishibashi, Shinji Nakashima, Yasuo Sugita, Osamu Miura, Koichi Ohshima |
Journal | European journal of haematology
(Eur J Haematol)
Vol. 91
Issue 1
Pg. 20-8
(Jul 2013)
ISSN: 1600-0609 [Electronic] England |
PMID | 23560463
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Copyright | © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd. |
Chemical References |
- Antimetabolites, Antineoplastic
- Immunoglobulin Heavy Chains
- Methotrexate
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Topics |
- Adult
- Aged
- Aged, 80 and over
- Antimetabolites, Antineoplastic
(therapeutic use)
- Arthritis, Rheumatoid
(complications, drug therapy, virology)
- Disease Progression
- Disease-Free Survival
- Female
- Herpesvirus 4, Human
(isolation & purification)
- Humans
- Immunoglobulin Heavy Chains
(genetics)
- Immunohistochemistry
- Lymphoproliferative Disorders
(chemically induced, complications)
- Male
- Methotrexate
(therapeutic use)
- Middle Aged
- Regression Analysis
- Treatment Outcome
- Virus Activation
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