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The incidence and prognosis of other iatrogenic immunodeficiency-associated lymphoproliferative disorders of the lung related to methotrexate: A retrospective study.
Torii, Atsushi; Oki, Masahide; Iida, Hiroatsu; Yamada, Arisa; Kogure, Yoshihito; Kitagawa, Chiyoe; Saka, Hideo.
Afiliación
  • Torii A; Department of Respiratory Medicine, National Hospital Organization Nagoya Medical Center, 4-1-1, Sannomaru, Naka-ku, Nagoya, Aichi, 460-0001, Japan. Electronic address: a51009068@gmail.com.
  • Oki M; Department of Respiratory Medicine, National Hospital Organization Nagoya Medical Center, 4-1-1, Sannomaru, Naka-ku, Nagoya, Aichi, 460-0001, Japan.
  • Iida H; Department of Hematology, National Hospital Organization Nagoya Medical Center, Japan.
  • Yamada A; Department of Respiratory Medicine, National Hospital Organization Nagoya Medical Center, 4-1-1, Sannomaru, Naka-ku, Nagoya, Aichi, 460-0001, Japan.
  • Kogure Y; Department of Respiratory Medicine, National Hospital Organization Nagoya Medical Center, 4-1-1, Sannomaru, Naka-ku, Nagoya, Aichi, 460-0001, Japan.
  • Kitagawa C; Department of Respiratory Medicine, National Hospital Organization Nagoya Medical Center, 4-1-1, Sannomaru, Naka-ku, Nagoya, Aichi, 460-0001, Japan.
  • Saka H; Department of Respiratory Medicine, National Hospital Organization Nagoya Medical Center, 4-1-1, Sannomaru, Naka-ku, Nagoya, Aichi, 460-0001, Japan.
Pulm Pharmacol Ther ; 85: 102297, 2024 Jun.
Article en En | MEDLINE | ID: mdl-38467341
ABSTRACT
BACKGROUND AND

OBJECTIVE:

Other iatrogenic immunodeficiency-associated lymphoproliferative disorders (OIIA-LPD) are rare but well-known diseases that manifest during or after methotrexate (MTX) administration. Limited information is available on the clinical characteristics of OIIA-LPD of the lung because only a few cases have been reported. Thus, we aimed to assess the incidence and prognosis of patients with OIIA-LPD of the lung.

METHODS:

Patients with OIIA-LPD of the lung treated at our institution between January 2008 and July 2020 were retrospectively analysed.

RESULTS:

Among the 51 patients with OIIA-LPD, 16 (31.3%, 7 men, 9 women) had OIIA-LPD of the lung (median age, 69 [range, 63-82] years). Peripheral lesions were observed in 10 (62.5%), central lesions in two (12.5%), and both lesions in four (25.0%) patients. Nine of the 16 patients underwent bronchoscopic biopsy, seven were diagnosed (diagnostic yield, 77.8%) and, re-biopsy was performed in 2 patients. Eight (50.0%) patients had LPD and six (37.5%) had diffuse large B-cell lymphoma. In the 14 patients with confirmed treatment efficacy, the overall response rate to MTX withdrawal was 71.4%. However, chemotherapy was required in case of larger lesions (three patients). Death related to OIIA-LPD occurred in only one patient, and 11 of the 14 patients were alive during the study period (median follow-up time, 53.7 [range, 4.3-84.2] months).

CONCLUSION:

The incidence of OIIA-LPD of the lung is 31.3% and higher than that reported previously. The treatment effect of MTX withdrawal seems to be sufficient; however, in some cases, chemotherapy may be required from the beginning.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Metotrexato / Enfermedad Iatrogénica / Trastornos Linfoproliferativos Límite: Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Pulm Pharmacol Ther Asunto de la revista: FARMACOLOGIA Año: 2024 Tipo del documento: Article Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Metotrexato / Enfermedad Iatrogénica / Trastornos Linfoproliferativos Límite: Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Pulm Pharmacol Ther Asunto de la revista: FARMACOLOGIA Año: 2024 Tipo del documento: Article Pais de publicación: Reino Unido