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Patients with rheumatoid arthritis often develop methotrexate‐associated lymphoproliferative disorders ( MTX ‐ LPD ) during  MTX  treatment.  MTX ‐ LPD  occasionally regresses spontaneously after simply discontinuing  MTX  treatment. In patients without spontaneous regression, additional chemotherapy is required to avoid disease progression. However, the differences between spontaneous and non‐spontaneous regression have yet to be elucidated. To clarify the factors important for spontaneous regression, we analyzed the clinicopathological features of 51 patients with rheumatoid arthritis who developed  MTX ‐ LPD  (diffuse large B‐cell lymphoma [ DLBCL ]‐type [ n =  34] and classical Hodgkin lymphoma [ CHL ]‐type [ n =  17]). We examined the interval from  MTX  discontinuation to the administration of additional chemotherapy. The majority of  DLBCL ‐type  MTX ‐ LPD  patients (81%) exhibited remission with  MTX  discontinuation alone. In contrast, the majority of  CHL ‐type  MTX ‐ LPD  patients (76%) required additional chemotherapy. This difference was statistically significant ( P =  0.001). However, overall survival was not significantly different between  DLBCL ‐type and  CHL ‐type (91%  vs  94%, respectively;  P >  0.05). Thus, the morphological differences in the pathological findings of  MTX ‐ LPD  may be a factor for spontaneous or non‐spontaneous regression after discontinuation of  MTX .

cancer science

Clinicopathological analysis of methotrexate‐associated lymphoproliferative disorders: Comparison of diffuse large B‐cell lymphoma and classical Hodgkin lymphoma types