Open AccessMethotrexate‐associated lymphoma in patients with rheumatoid arthritis. Report of two cases
Author(s) -
Bachman Teresa R.,
Sawitzke Allen D.,
Perkins Sherrie L.,
Ward John H.,
Can Grant W.
Publication year - 1996
Publication title -
arthritis & rheumatism
Language(s) - English
Resource type - Journals
eISSN - 1529-0131
pISSN - 0004-3591
DOI - 10.1002/art.1780390223
Subject(s) - medicine , rheumatoid arthritis , methotrexate , discontinuation , lymphoma , epstein–barr virus , lymphoproliferative disorders , biopsy , population , chemotherapy , immunology , gastroenterology , oncology , pathology , dermatology , virus , environmental health
This report describes 2 patients with longstanding seropositive rheumatoid arthritis (RA) treated with oral methotrexate (MTX) who developed large cell lymphoma of B cell phenotype. In situ hybridization studies showed nuclear staining for Epstein‐Barr virus (EBV) within the malignant lymphoid cells. In both cases, the lymphoma was undetectable several weeks after diagnostic biopsy followed by discontinuation of MTX. These observations suggest that, in patients with RA who develop an EBV‐associated lymphoproliferative disorder, a trial of discontinuation of immunosuppressive agents may be warranted before chemotherapy is considered. In addition, there is a need for a heightened awareness of the development of lymphoma in this patient population.