Atypical lymphoproliferation progressing into B-cell lymphoma in rheumatoid arthritis treated with different biological agents: Clinical course and molecular characterization

Luca Quartuccio, Valli De Re, Martina Fabris, Alessandra Marzotto, Nicoletta Franzolini, Daniela Gasparotto, Laura Caggiari, Gianfranco Ferraccioli, Cathryn Anne Scott, Salvatore De Vita

Research output: Contribution to journalArticlepeer-review

Abstract

A patient with rheumatoid arthritis (RA) developed an atypical lymphoproliferative disorder (LPD) after methotrexate and cyclosporine A, which regressed after suspension of both drugs. After subsequent treatment with rituximab, the LPD was still undetectable. Anti-tumor necrosis factor α therapy was used when the arthritis relapsed, but an aggressive B-cell non Hodgkin's lymphoma developed. Molecular analyses showed an oligoclonal B-cell expansion at the LPD step. A minor clone with significant sequence homology to B-cell lymphomas arising in Sjögren's syndrome and mixed cryoglobulinemia syndrome, given rise to the non-Hodgkin's lymphoma. Treatment of rheumatoid arthritis associated with lymphoproliferation represents a clinical challenge, and common pathogenetic pathways to lymphoma may occur in different autoimmune diseases.

Original languageEnglish
Pages (from-to)691-694
Number of pages4
JournalHaematologica
Volume91
Issue number5
Publication statusPublished - May 2006

Keywords

  • Lymphoma
  • Rheumatoid arthritis
  • Rituximab
  • Tumor necrosis factor

ASJC Scopus subject areas

  • Hematology

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