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The clinical impact of absolute lymphocyte count in peripheral blood among patients with methotrexate - associated lymphoproliferative disorders.
- Source :
-
Journal of clinical and experimental hematopathology : JCEH [J Clin Exp Hematop] 2020 Jun 20; Vol. 60 (2), pp. 41-50. Date of Electronic Publication: 2020 May 13. - Publication Year :
- 2020
-
Abstract
- Regressive lymphoproliferative disorders (R-LPD) after methotrexate (MTX) withdrawal are one of the specific features of methotrexate - associated lymphoproliferative disorders (MTX-LPD). Although the impact of the absolute lymphocyte count (ALC) on the pathogenesis of R-LPD has been recently emphasized, understanding relapse/regrowth events (RRE) and differences among LPD subtypes is necessary. In this study, we confirmed ALC recovery in the regressive group (R-G; R-LPD without RRE) and relapse/regrowth group (R/R-G; R-LPD with RRE). The increase in ALC lasted at least 2 years in R-G, whereas it decreased within 3 years in R/R-G, supporting the better overall survival (OS) in R-G, as previously reported. In addition, our study suggested that an ALC of 1000/µL at the time of development of LPD is a significant predictor for treatment-free survival (TFS). Furthermore, an ALC of 1000/µL at 6 months after MTX withdrawal was found to be a significant indicator of TFS and OS for R-G and R/R-G. The ALC decreased gradually before LPD development in R/R-G, whereas it decreased 6 months before LPD development in R-G, confirming the important role of ALC in the pathogenesis of MTX-LPD such as regressive events and RRE. In addition to ALC, other predictive factors, such as serum C-reactive protein and soluble interleukin-2 receptors, may be helpful in the management of MTX-LPD, including the decision making for an additional chemotherapy for regressive LPD after MTX withdrawal.
- Subjects :
- Adult
Aged
Aged, 80 and over
Antirheumatic Agents therapeutic use
Arthritis, Rheumatoid complications
Arthritis, Rheumatoid drug therapy
Female
Humans
Lymphocyte Count
Lymphoproliferative Disorders blood
Lymphoproliferative Disorders diagnosis
Male
Methotrexate therapeutic use
Middle Aged
Prognosis
Retrospective Studies
Antirheumatic Agents adverse effects
Lymphoproliferative Disorders chemically induced
Methotrexate adverse effects
Subjects
Details
- Language :
- English
- ISSN :
- 1880-9952
- Volume :
- 60
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Journal of clinical and experimental hematopathology : JCEH
- Publication Type :
- Academic Journal
- Accession number :
- 32404570
- Full Text :
- https://doi.org/10.3960/jslrt.19039