{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T05:20:49Z","timestamp":1793164849420,"version":"4.5.0"},"reference-count":34,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2013,5,13]],"date-time":"2013-05-13T00:00:00Z","timestamp":1368403200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["European J of Haematology"],"published-print":{"date-parts":[[2013,7]]},"abstract":"Abstract<\/jats:title>Objectives<\/jats:title>Patients with rheumatoid arthritis (RA<\/jats:styled-content>) may develop lymphoproliferative disorders (RA<\/jats:styled-content>\u2010LPD<\/jats:styled-content>). Immunosuppressive states due to methotrexate (MTX<\/jats:styled-content>) and Epstein\u2013Barr virus (EBV<\/jats:styled-content>) reactivation have been regarded as causes. Sometimes spontaneous regression occurs after withdrawal of MTX<\/jats:styled-content>. The objective of this study was to identify factors predictive of relapse and survival in patients with RA<\/jats:styled-content>\u2010LPD<\/jats:styled-content>, and spontaneous regression in patients with RA<\/jats:styled-content>\u2010LPD<\/jats:styled-content> treated with MTX<\/jats:styled-content> (MTX<\/jats:styled-content>\u2010LPD<\/jats:styled-content>).<\/jats:p><\/jats:sec>Methods<\/jats:title>We evaluated the clinicopathological features, clinical characteristics, and treatment outcomes in 102 cases of RA<\/jats:styled-content>\u2010LPD<\/jats:styled-content>. In addition, EBV<\/jats:styled-content> infection and clonality of immunoglobulin heavy chain gene (IGH<\/jats:styled-content>) were analyzed by in situ<\/jats:italic> hybridization and polymerase chain reaction, respectively.<\/jats:p><\/jats:sec>Results<\/jats:title>The 102 cases included patients with diffuse large B<\/jats:styled-content>\u2010cell lymphoma (DLBCL<\/jats:styled-content>; n<\/jats:italic>\u00a0=\u00a053), H<\/jats:styled-content>odgkin lymphoma (n<\/jats:italic>\u00a0=\u00a09), polymorphic B<\/jats:styled-content>\u2010cell LPD<\/jats:styled-content> (n<\/jats:italic>\u00a0=\u00a020), reactive lymphadenitis (n<\/jats:italic>\u00a0=\u00a011), peripheral T<\/jats:styled-content>\u2010cell lymphoma (PTCL<\/jats:styled-content>; n<\/jats:italic>\u00a0=\u00a04), composite lymphoma (n<\/jats:italic>\u00a0=\u00a02), and follicular lymphoma (n<\/jats:italic>\u00a0=\u00a03). EBV<\/jats:styled-content> was detected in 60% (56\/93) of patients. Spontaneous regression occurred in 59% (28\/47) of patients in whom MTX<\/jats:styled-content> was withdrawn. Regression was associated with EBV<\/jats:styled-content> positivity (P<\/jats:italic>\u00a0=\u00a00.007) and non\u2010DLBCL<\/jats:styled-content> (P<\/jats:italic>\u00a0=\u00a00.006), but not with MTX<\/jats:styled-content> amount and other clinical features. Monoclonal bands of IGH<\/jats:styled-content> were observed in 31 of 74 cases. In patients with DLBCL<\/jats:styled-content>, poor disease\u2010free survival (P<\/jats:italic>\u00a0=\u00a00.05) was associated with clonality of IGH<\/jats:styled-content>. In all patients, factors predictive of shorter survival were age (>70\u00a0yr) and histological type of DLBCL<\/jats:styled-content>.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>Histology, EBV<\/jats:styled-content> positivity, and monoclonality of IGH<\/jats:styled-content> are useful for predicting clinical outcomes in patients with RA<\/jats:styled-content>\u2010LPD<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ejh.12116","type":"journal-article","created":{"date-parts":[[2013,4,6]],"date-time":"2013-04-06T06:44:01Z","timestamp":1365230641000},"page":"20-28","source":"Crossref","is-referenced-by-count":231,"title":["Methotrexate\/iatrogenic lymphoproliferative disorders in rheumatoid arthritis: histology, E<\/scp>pstein\u2013B<\/scp>arr virus, and clonality are important predictors of disease progression and regression"],"prefix":"10.1111","volume":"91","author":[{"given":"Ayako","family":"Ichikawa","sequence":"first","affiliation":[{"name":"Department of 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