Immunomodulator agent-related lymphoproliferative disorders.

Details

Serval ID
serval:BIB_871D5CB789F8
Type
Article: article from journal or magazin.
Collection
Publications
Title
Immunomodulator agent-related lymphoproliferative disorders.
Journal
Modern Pathology
Author(s)
Hasserjian R.P., Chen S., Perkins S.L., de Leval L., Kinney M.C., Barry T.S., Said J., Lim M.S., Finn W.G., Medeiros L.J., Harris N.L., O'Malley D.P.
ISSN
0893-3952
ISSN-L
1530-0285[electronic]
Publication state
Published
Issued date
2009
Volume
22
Number
12
Pages
1532-1540
Language
english
Abstract
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.
Keywords
Adult, Aged, Antineoplastic Agents/therapeutic use, Autoimmune Diseases/drug therapy, Autoimmune Diseases/immunology, Belgium, Female, Herpesvirus 4, Human/isolation & purification, Hodgkin Disease/chemically induced, Humans, Iatrogenic Disease, Immunologic Factors/adverse effects, Immunosuppressive Agents/adverse effects, Lymphoma, B-Cell/chemically induced, Lymphoma, T-Cell/chemically induced, Lymphoproliferative Disorders/chemically induced, Lymphoproliferative Disorders/drug therapy, Male, Middle Aged, Treatment Outcome, United States, Young Adult
Pubmed
Open Access
Yes
Create date
22/10/2010 13:35
Last modification date
20/08/2019 14:46
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