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Original Article
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Volume 328:1317-1321 May 6, 1993 Number 18
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Reversible Lymphomas Associated with Epstein-Barr Virus Occurring during Methotrexate Therapy for Rheumatoid Arthritis and Dermatomyositis
Onsi W. Kamel, Matthijs van de Rijn, Lawrence M. Weiss, Gregory J. Del Zoppo, P. Kahler Hench, Bruce A. Robbins, Paul G. Montgomery, Roger A. Warnke, and Ronald F. Dorfman

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An increased risk of lymphoproliferative disorders has been well documented in patients who are treated with immunosuppressive agents after organ transplantation1 and in patients with the acquired immunodeficiency syndrome2. The lymphomas that develop in immunosuppressed patients after transplantation are typically large-cell lymphomas that contain Epstein-Barr virus (EBV) and are closely linked to the level of competence of the immune system3. When treatment with immunosuppressive drugs is reduced or discontinued, these EBV-associated lymphomas may regress completely1; if the patient's immune status continues to be compromised, however, the tumor may continue to proliferate and result in death.

Whether patients . . . [Full Text of this Article]

Case Reports

Patient 1

Patient 2

Methods

Histologic and Immunohistochemical Studies

Studies of In Situ Hybridization

Results

Patient 1

Patient 2

Discussion


Source Information

From the Department of Pathology, Stanford University Medical Center, Stanford, Calif. (O.W.K., M.R., R.A.W., R.F.D.); the Department of Pathology, City of Hope National Medical Center, Duarte, Calif. (L.M.W.); the Department of Molecular and Experimental Medicine and Division of Hematology/Medical Oncology (G.J.D.Z.), the Division of Rheumatology (P.K.H.), and the Department of Pathology (B.A.R.), Scripps Clinic and Research Foundation, La Jolla, Calif.; and the Division of Hematology/Oncology, Mountain States Tumor Institute, Boise, Idaho (P.G.M.).

Address reprint requests to Dr. Kamel at the Department of Pathology, Stanford University Medical Center, 300 Pasteur Dr., Stanford, CA 94305.

References


Related Letters:

Reversible Lymphomas
Shiroky J. B., Newkirk M. M., Kamel O. W., van de Rijn M., Warnke R. A., Dorfman R. F.
Extract | Full Text  
N Engl J Med 1993; 329:1657-1658, Nov 25, 1993. Correspondence

Cyclosporine and Methotrexate for Severe Rheumatoid Arthritis
Schlesinger N., Huppert A., Hoch S., Malleson P., Steinberg A. D., Rosh J. R., Birnbaum A. H., van de Rijn M., Kamel O. W., Storb R., Thomas E. D., Tugwell P., Yocum D., Pincus T., Wells G.
Extract | Full Text  
N Engl J Med 1995; 333:1567-1569, Dec 7, 1995. Correspondence

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