与甲氨蝶呤有关的其他先天性免疫缺陷相关肺部淋巴组织增生性疾病的发病率和预后:一项回顾性研究。

IF 3.3 3区 医学 Q2 PHARMACOLOGY & PHARMACY
Atsushi Torii , Masahide Oki , Hiroatsu Iida , Arisa Yamada , Yoshihito Kogure , Chiyoe Kitagawa , Hideo Saka
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引用次数: 0

摘要

背景和目的:其他先天性免疫缺陷相关淋巴组织增生性疾病(OIIA-LPD)是一种罕见但众所周知的疾病,在服用甲氨蝶呤(MTX)期间或之后出现。有关肺部 OIIA-LPD 临床特征的信息非常有限,因为只有少数病例被报道过。因此,我们旨在评估肺部 OIIA-LPD 患者的发病率和预后:方法:对2008年1月至2020年7月期间在我院接受治疗的肺部OIIA-LPD患者进行回顾性分析:51例OIIA-LPD患者中,16例(31.3%,男性7例,女性9例)为肺部OIIA-LPD(中位年龄69岁[范围63-82岁])。10名患者(62.5%)出现周围病变,2名患者(12.5%)出现中心病变,4名患者(25.0%)同时出现两种病变。16 名患者中有 9 人接受了支气管镜活检,7 人确诊(诊断率为 77.8%),2 人进行了再次活检。8名患者(50.0%)患有LPD,6名患者(37.5%)患有弥漫大B细胞淋巴瘤。在 14 名疗效得到确认的患者中,停用 MTX 后的总体反应率为 71.4%。然而,如果病灶较大(3 名患者),则需要进行化疗。研究期间,14 名患者中有 11 人存活(中位随访时间为 53.7 个月[4.3-84.2 个月]):结论:肺部OIIA-LPD的发病率为31.3%,高于之前的报道。结论:肺部 OIIA-LPD 的发病率为 31.3%,高于之前的报道。停用 MTX 的治疗效果似乎足够好,但在某些情况下,可能需要从一开始就进行化疗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The incidence and prognosis of other iatrogenic immunodeficiency-associated lymphoproliferative disorders of the lung related to methotrexate: A retrospective study

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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来源期刊
CiteScore
6.20
自引率
0.00%
发文量
41
审稿时长
42 days
期刊介绍: Pulmonary Pharmacology and Therapeutics (formerly Pulmonary Pharmacology) is concerned with lung pharmacology from molecular to clinical aspects. The subject matter encompasses the major diseases of the lung including asthma, cystic fibrosis, pulmonary circulation, ARDS, carcinoma, bronchitis, emphysema and drug delivery. Laboratory and clinical research on man and animals will be considered including studies related to chemotherapy of cancer, tuberculosis and infection. In addition to original research papers the journal will include review articles and book reviews. Research Areas Include: • All major diseases of the lung • Physiology • Pathology • Drug delivery • Metabolism • Pulmonary Toxicology.
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