Characteristics of patients with juvenile arthritis developing lymphoma while treated with MTX
| Ref. | Diagnosis | Duration of MTX therapy | Other therapy during treatment with MTX | Cell type | Spontaneous remission on stopping MTX | Outcome |
|---|---|---|---|---|---|---|
| *MTX discontinued for eight weeks during proven EBV infection 21 months prior to presentation with nodular sclerosing Hodgkin's lymphoma. | ||||||
| †MTX discontinued for two months during episode of intercurrent pneumonia. | ||||||
| ‡MTX discontinued after 20 months due to disease remission, and recommenced after one year due to relapse. | ||||||
| 2 | Systemic JIA Mixed cellularity Hodgkin's lymphoma | 16 months | Prednisolone | CD30 CD15 EBV neg | Yes | Late LPD relapse Autologous stem cell transplantation |
| 3 | Systemic JIA Nodular sclerosing Hodgkin's lymphoma | 33 months* | Not known | CD30 EBV pos | Not attempted | Remission of LPD and JIA |
| 4 | Polyarthritis (RF positive) Nodular sclerosing Hodgkin's lymphoma | 30 months† | Prednisolone Cyclosporin A | CD30 CD15 CD20 LMP1 EBV pos | Not applicable | Death (respiratory failure secondary to legionella pneumonia) |
| 5 | Polyarthritis (RF negative) Nodular sclerosing Hodgkin's disease | 21 months‡ | Sulphasalazine | EBV negative | Partial response | Remission of LPD and JIA after 12 months follow up |
| Our case | Polyarthritis Non-Hodgkin's lymphoma | 32 months | Prednisolone Intra-articular steroids | CD79A CD20Y CD45RA | No | Remission of LPD Relapse of polyarthritis |