{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,15]],"date-time":"2026-11-15T03:03:41Z","timestamp":1794711821332,"version":"4.9.1"},"reference-count":25,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,7]]},"abstract":"<jats:p>\n                    Methotrexate (MTX) carries a risk of lymphoproliferative disorders (LPDs), but MTX-associated LPDs (MTX-LPDs) can resolve spontaneously after MTX withdrawal. However, the precise clinicopathologic features of MTX-LPD remain unclear. We aimed to investigate the clinicopathologic characteristics, outcomes, and prognostic factors for histologic types of MTX-LPD. Paraffin-embedded tissue samples of 219 patients with MTX-LPD were analyzed. In total, 30,33,106, and 26 had reactive lymphoid hyperplasia (RH), polymorphic-LPD (Poly-LPD), diffuse large B-cell lymphomas (DLBCLs), and classic Hodgkin lymphoma (CHL), respectively. The clinicopathologic features of RH, Poly-LPD, DLBCLs, and CHL were as follows: extranodal involvement: 13.8% (4\/29), 36.4% (12\/33), 69.5% (73\/105), and 15.4% (4\/26); Epstein-Barr virus encoded RNA positivity: 55.2% (16\/29), 71.9% (23\/32), 45.3% (48\/106), and 76.9% (20\/26); necrosis: 0% (0\/29), 51.5% (17\/33), 34.3% (36\/105), and 12.0% (3\/25); and Hodgkin Reed-Sternberg-like cells: 17.2% (5\/29), 50% (14\/28), and 19.8% (21\/106). The median duration from MTX withdrawal to the time of disease regression was 10.4, 3.0, 4.2, and 2.7 months for RH, Poly-LPD, DLBCLs, and CHL. After MTX withdrawal, progression-free survival was the greatest for RH, followed by for Poly-LPD, DLBCL, and CHL (all\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    &lt;0.05). Overall survival did not differ significantly between the groups. On univariate analysis, the predictive factors for progression-free survival included plasma cell infiltrate for CHL, eosinophil infiltrate, age above 70 years, and extensive necrosis for Poly-LPD, while they were Epstein-Barr virus encoded RNA positivity and International Prognostic Index risk for DLBCL on multivariate analysis. In conclusion, histologic categorization and histology-specific factors could be useful for predicting MTX-LPD progression after MTX withdrawal.\n                  <\/jats:p>","DOI":"10.1097\/pas.0000000000001271","type":"journal-article","created":{"date-parts":[[2019,5,6]],"date-time":"2019-05-06T18:11:02Z","timestamp":1557166262000},"page":"869-884","source":"Crossref","is-referenced-by-count":103,"title":["Methotrexate-associated Lymphoproliferative Disorders in Patients With Rheumatoid Arthritis"],"prefix":"10.1097","volume":"43","author":[{"given":"Daisuke","family":"Kurita","sequence":"first","affiliation":[{"name":"Pathology"},{"name":"Laboratory of Virus Control, Institute for Frontier Life and Medical Science, Kyoto University, Kyoto"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroaki","family":"Miyoshi","sequence":"additional","affiliation":[{"name":"Pathology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayako","family":"Ichikawa","sequence":"additional","affiliation":[{"name":"Pathology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koji","family":"Kato","sequence":"additional","affiliation":[{"name":"Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshitaka","family":"Imaizumi","sequence":"additional","affiliation":[{"name":"Department of Hematology, Nagasaki University Hospital, Nagasaki"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ritsuko","family":"Seki","sequence":"additional","affiliation":[{"name":"Medicine, Division of Hematology and Oncology, Kurume University School of Medicine, Kurume"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kensaku","family":"Sato","sequence":"additional","affiliation":[{"name":"Pathology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuya","family":"Sasaki","sequence":"additional","affiliation":[{"name":"Pathology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keisuke","family":"Kawamoto","sequence":"additional","affiliation":[{"name":"Pathology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joji","family":"Shimono","sequence":"additional","affiliation":[{"name":"Pathology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyohei","family":"Yamada","sequence":"additional","affiliation":[{"name":"Pathology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reiji","family":"Muto","sequence":"additional","affiliation":[{"name":"Pathology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahiro","family":"Kizaki","sequence":"additional","affiliation":[{"name":"Division of Hematology, Saitama Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koji","family":"Nagafuji","sequence":"additional","affiliation":[{"name":"Medicine, Division of Hematology and Oncology, Kurume University School of Medicine, Kurume"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun-ichi","family":"Tamaru","sequence":"additional","affiliation":[{"name":"Department of Pathology, Saitama Medical Center, Saitama Medical University, Saitama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michihide","family":"Tokuhira","sequence":"additional","affiliation":[{"name":"Division of Hematology, Saitama Medical 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Factors"],"short-title":[],"issued":{"date-parts":[[2019,7]]},"references-count":25,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2019]]}},"URL":"https:\/\/doi.org\/10.1097\/pas.0000000000001271","relation":{},"ISSN":["0147-5185"],"issn-type":[{"value":"0147-5185","type":"print"}],"subject":[],"published":{"date-parts":[[2019,7]]}}}