PMID- 19767727
OWN - NLM
STAT- MEDLINE
DCOM- 20100128
LR  - 20230210
IS  - 1530-0285 (Electronic)
IS  - 0893-3952 (Linking)
VI  - 22
IP  - 12
DP  - 2009 Dec
TI  - Immunomodulator agent-related lymphoproliferative disorders.
PG  - 1532-40
LID - 10.1038/modpathol.2009.131 [doi]
AB  - The recent development of inhibitors of key immune response proteins has 
      revolutionized the therapy of autoimmune diseases; these immunomodulator agents 
      include monoclonal antibodies and receptor antagonists. However, as with all 
      therapies, these new agents are not without side effects and complications. In 
      particular, anti-tumor necrosis factor alpha (TNFalpha) agents have been reported 
      to be associated with an increased incidence of lymphoproliferative disorders, 
      infections, and vasculitis. We evaluated the clinicopathological features of 18 
      cases of immunomodulator agent-related lymphoproliferative disorders (IAR-LPD) 
      from several institutions. These included 6 cases of B-cell lymphoma, 2 cases of 
      T-cell lymphoma, 3 cases of classical Hodgkin lymphoma, and 7 atypical lymphoid 
      proliferations that did not fulfill diagnostic criteria for lymphoma; two of the 
      latter regressed after discontinuation of the immunomodulator agent therapy. All 
      eight lymphoma patients with available information had also received prior 
      chemotherapy (methotrexate or 6-mercaptopurine). EBV was strongly associated with 
      the B-cell and classical Hodgkin lymphomas. This case series illustrates that a 
      broad range of lymphoid proliferations can occur after immunomodulator agent 
      therapy and that these immunomodulator agent-related lymphoproliferative 
      disorders have considerable overlap with other well-defined lymphoproliferative 
      diseases associated with iatrogenic immunosuppression. Further study is warranted 
      to evaluate how these therapies interact with other immunosuppressive agents and 
      the underlying abnormal immune system to enhance the development of lymphomas and 
      atypical lymphoid proliferations.
FAU - Hasserjian, Robert P
AU  - Hasserjian RP
AD  - Department of Pathology, Massachusetts General Hospital, Boston, MA 02114, USA. 
      rhasserjian@partners.org
FAU - Chen, Steve
AU  - Chen S
FAU - Perkins, Sherrie L
AU  - Perkins SL
FAU - de Leval, Laurence
AU  - de Leval L
FAU - Kinney, Marsha C
AU  - Kinney MC
FAU - Barry, Todd S
AU  - Barry TS
FAU - Said, Jonathan
AU  - Said J
FAU - Lim, Megan S
AU  - Lim MS
FAU - Finn, William G
AU  - Finn WG
FAU - Medeiros, L Jeffrey
AU  - Medeiros LJ
FAU - Harris, Nancy L
AU  - Harris NL
FAU - O'Malley, Dennis P
AU  - O'Malley DP
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
DEP - 20090918
PL  - United States
TA  - Mod Pathol
JT  - Modern pathology : an official journal of the United States and Canadian Academy 
      of Pathology, Inc
JID - 8806605
RN  - 0 (Antineoplastic Agents)
RN  - 0 (Immunologic Factors)
RN  - 0 (Immunosuppressive Agents)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Antineoplastic Agents/therapeutic use
MH  - Autoimmune Diseases/*drug therapy/immunology
MH  - Belgium
MH  - Female
MH  - Herpesvirus 4, Human/isolation & purification
MH  - Hodgkin Disease/chemically induced
MH  - Humans
MH  - *Iatrogenic Disease
MH  - Immunologic Factors/*adverse effects
MH  - Immunosuppressive Agents/adverse effects
MH  - Lymphoma, B-Cell/chemically induced
MH  - Lymphoma, T-Cell/chemically induced
MH  - Lymphoproliferative Disorders/*chemically induced/drug therapy/pathology/virology
MH  - Male
MH  - Middle Aged
MH  - Treatment Outcome
MH  - United States
MH  - Young Adult
EDAT- 2009/09/22 06:00
MHDA- 2010/01/29 06:00
CRDT- 2009/09/22 06:00
PHST- 2009/09/22 06:00 [entrez]
PHST- 2009/09/22 06:00 [pubmed]
PHST- 2010/01/29 06:00 [medline]
AID - S0893-3952(22)02424-3 [pii]
AID - 10.1038/modpathol.2009.131 [doi]
PST - ppublish
SO  - Mod Pathol. 2009 Dec;22(12):1532-40. doi: 10.1038/modpathol.2009.131. Epub 2009 
      Sep 18.