関節リウマチ関連リンパ増殖性疾患の診断と管理の手引き

出版社: 羊土社
著者:
発行日: 2022-07-15
分野: 臨床医学:内科  >  血液
ISBN: 9784758123921
電子書籍版: 2022-07-15 (第1刷)
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MTXなどの免疫抑制薬治療中のRAに発生するリンパ増殖性疾患(LPD)に適切に対応するため,関連3学会WGがまとめた本邦初の手引き.最新エビデンスをもとに,RA-LPD診断・管理の重要ポイントがわかる

目次

  • 【1】緒言
    (1) はじめに
    (2) RA治療薬開発の歴史
    (3) RA治療戦略の変遷
    (4)『関節リウマチ関連リンパ増殖性疾患の診断と管理の手引き』作成にあたって

    【2】リンパ腫/リンパ増殖性疾患の概念と定義

    【3】関節リウマチとリンパ腫/リンパ増殖性疾患
    (1) 自己免疫疾患とリンパ腫
    (2) 諸外国におけるRA患者のリンパ腫の相対リスクと罹患率
    (3) 本邦におけるRA関連LPDの発生状況
    (4) RA患者におけるリンパ腫/LPDの発生要因

    【4】WHO分類(病理学的分類)
    (1) WHO分類の歴史,流れ
    (2) 悪性リンパ腫の分類/診断のとらえ方
    (3) 悪性リンパ腫の分類

    【5】関節リウマチ関連リンパ増殖性疾患の病理学的特徴と診断名
    (1) 免疫不全関連LPDの分類
    (2) RA患者に発生したその他の医原性免疫不全関連LPDの病理組織像

    【6】関節リウマチ患者に発生するリンパ増殖性疾患の危険因子と発症前の徴候,検査異常
    (1) LPD発症に関与する因子(危険因子)
    (2) LPD発症前の徴候,検査異常

    【7】関節リウマチ関連リンパ増殖性疾患の臨床的特徴
    (1) 臨床症状と徴候
    (2) 検査値異常

    【8】診断手順:必要な検査,コンサルテーションのタイミング
    (1) リウマチ医の立場から〜LPDを疑ったときの初期対応
    (1) 病理診断医の立場から〜リンパ節生検,節外病変生検で何を検査するか

    【9】リンパ増殖性疾患の経過・予後と発生時の対応 
    (1) 自然消退例と非消退例の臨床・病理学的特徴
    (2) 自然消退の時間的経過および副腎皮質ステロイドの消退過程への影響
    (3) 血液内科および他科へのコンサルテーションのタイミング
    (4) 自然消退して再発しない例と再発する例の比率と再発例の患者背景
    (5) 生命予後と生命予後に影響する因子

    【10】リンパ増殖性疾患が疑われる関節リウマチ患者への血液内科医の対応と
        代表的病理組織型別治療
    (1) RA関連LPD患者における対応の流れ〜血液内科医の立場から
    (2) RA関連LPD治療の考え方
    (3) 生検が行われなかったLPD疑い患者のフォローアップ
    (4) 各RA関連LPD亜型における治療方法

    【11】リンパ腫/リンパ増殖性疾患の消退/寛解後の関節リウマチ治療(推奨される薬剤)
    (1) LPD自然消退例あるいは治療後寛解に至った症例のRA疾患活動性コントロール状態とRA治療の現状
    (2) LPD発症後の生物学的製剤治療

この書籍の参考文献

参考文献のリンクは、リンク先の都合等により正しく表示されない場合がありますので、あらかじめご了承下さい。

本参考文献は電子書籍掲載内容を元にしております。

1 緒言

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2 リンパ腫 / リンパ増殖性疾患の概念と定義

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4 WHO分類 ( 病理学的分類 )

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3) Ohshima K, et al : The World Health Organization classification of malignant lymphoma : incidence and clinical prognosis in HTLV-1-endemic area of Fukuoka. Pathol Int, 52 : 1-12, 2002 (PMID : 11940200)

5 関節リウマチ関連リンパ増殖性疾患の病理学的特徴と診断名

P.65 掲載の参考文献
1) 「WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues, Revised 4th Edition」 (Swerdlow SH, et al, eds), IARC Press, 2017
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3) 「リンパ腫アトラス 第5版」 (中村栄男, 他/編), 文光堂, 2018
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7) Honda S, et al : Association of methotrexate use and lymphoproliferative disorder in patients with rheumatoid arthritis : Results from a Japanese multi-institutional retrospective study. Mod Rheumatol, 32 : 16-23, 2022 (PMID : 33428479)
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6 関節リウマチ患者に発生するリンパ増殖性疾患の危険因子と発症前の徴候, 検査異常

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10) Shimizu Y, et al : Characteristics and risk factors of lymphoproliferative disorders among patients with rheumatoid arthritis concurrently treated with methotrexate : a nested case-control study of the IORRA cohort. Clin Rheumatol, 36 : 1237-1245, 2017 (PMID : 28455827)
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20) Kameda T, et al : Association of higher methotrexate dose with lymphoproliferative disease onset in rheumatoid arthritis patients. Arthritis Care Res (Hoboken), 66 : 1302-1309, 2014 (PMID : 24515570)
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22) Niens M, et al : HLA-A*02 is associated with a reduced risk and HLA-A*01 with an increased risk of developing EBV+ Hodgkin lymphoma. Blood, 110 : 3310-3315, 2007 (PMID : 17630352)
23) Diepstra A, et al : Association with HLA class I in Epstein-Barr-virus-positive and with HLA class III in Epstein-Barr-virus-negative Hodgkin's lymphoma. Lancet, 365 : 2216-2224, 2005 (PMID : 15978930)
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7 関節リウマチ関連リンパ増殖性疾患の臨床的特徴

P.81 掲載の参考文献
1) Takada H, et al : Clinicopathological characteristics of lymphoproliferative disorders in 232 patients with rheumatoid arthritis in Japan : A retrospective, multicenter, descriptive study. Mod Rheumatol, 32 : 32-40, 2022 (PMID : 33705243)
2) Honda S, et al : Association of methotrexate use and lymphoproliferative disorder in patients with rheumatoid arthritis : Results from a Japanese multi-institutional retrospective study. Mod Rheumatol, 32 : 16-23, 2022 (PMID : 33428479)
3) 鈴木康夫, 他 : 関節リウマチ関連リンパ増殖性疾患の診断と管理. 『令和2年度厚生労働行政推進調査事業費補助金 (免疫・アレルギー疾患政策研究事業) 「我が国の関節リウマチ診療の標準化に関する臨床疫学研究」 (H30-免疫-指定-002) 分担研究報告書』, 2021 https://mhlw-grants.niph.go.jp/system/files/report_pdf/202013002A%20--buntan2_0.pdf (2022年3月閲覧)
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5) Tokuhira M, et al : Clinicopathologic investigation of methotrexate-induced lymphoproliferative disorders, with a focus on regression. Leuk Lymphoma, 59 : 1143-1152, 2018 (PMID : 28877615)
6) Tokuhira M, et al : Clinicopathological features of clinical methotrexate-related lymphoproliferative disorders. Leuk Lymphoma, 60 : 2508-2515, 2019 (PMID : 30947579)
7) Saito R, et al : Overall survival and post-spontaneous regression relapse-free survival of patients with lymphoproliferative disorders associated with rheumatoid arthritis : a multi-center retrospective cohort study. Mod Rheumatol, 32 : 50-58, 2022 (PMID : 33336615)
8) Saito S, et al : Distinct patterns of lymphocyte count transition in lymphoproliferative disorder in patients with rheumatoid arthritis treated with methotrexate. Rheumatology (Oxford), 56 : 940-946, 2017 (PMID : 28165538)

8 診断手順 : 必要な検査, コンサルテーションのタイミング

P.87 掲載の参考文献
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5) Kuramoto N, et al : Characteristics of rheumatoid arthritis with immunodeficiency-associated lymphoproliferative disorders to regress spontaneously by the withdrawal of methotrexate and their clinical course : A retrospective, multicenter, case-control study. Mod Rheumatol, 32 : 24-31, 2022 (PMID : 33496194)
6) 伊豆津宏二 : 第III章-1. リンパ節腫大, 扁桃腫大, 肝脾腫の鑑別. 「血液専門医テキスト 改訂第3版」 (日本血液学会/編), pp29-32, 南江堂, 2019
7) 伊豆津宏二 : 第IV章-9. リンパ節生検時の検査. 「血液専門医テキスト 改訂第3版」 (日本血液学会/編), pp166-178, 南江堂, 2019
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5) Raab-Traub N & Flynn K : The structure of the termini of the Epstein-Barr virus as a marker of clonal cellular proliferation. Cell, 47 : 883-889, 1986 (PMID : 3022942)

9 リンパ増殖性疾患の経過・予後と発生時の対応

P.110 掲載の参考文献
1) 「関節リウマチ治療におけるメトトレキサート (MTX) 診療ガイドライン 2016年改訂版」 (日本リウマチ学会MTX診療ガイドライン策定小委員会/編), 羊土社, 2016
2) Gaula rd P, e t a l : 16 I mmunodef iciency-associated l ymphoproliferat ive disorders. Ot her iatrogenic immunodeficiency-associated lymphoproliferative disorders.「WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues, Revised 4th Edition」 (Swerdlow SH, et al, eds), pp462-464, IARC Press, 2017
3) Ichikawa A, et al : Methotrexate/iatrogenic lymphoproliferative disorders in rheumatoid arthritis : histology, Epstein-Barr virus, and clonality are important predictors of disease progression and regression. Eur J Haematol, 91 : 20-28, 2013 (PMID : 23560463)
4) Gion Y, et al : Clinicopathological analysis of methotrexate-associated lymphoproliferative disorders : Comparison of diffuse large B-cell lymphoma and classical Hodgkin lymphoma types. Cancer Sci, 108 : 1271-1280, 2017 (PMID : 28380678)
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7) Kuramoto N, et al : Characteristics of rheumatoid arthritis with immunodeficiency-associated lymphoproliferative disorders to regress spontaneously by the withdrawal of methotrexate and their clinical course : A retrospective, multicenter, case-control study. Mod Rheumatol, 32 : 24-31, 2022 (PMID : 33496194)
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11) Katsuyama T, et al : Prognostic factors of methotrexate-associated lymphoproliferative disorders associated with rheumatoid arthritis and plausible application of biological agents. Mod Rheumatol, 27 : 773-777, 2017 (PMID : 27846761)
12) Fujimoto K, et al : Association of Epstein-Barr virus with regression after withdrawal of immunosuppressive drugs and subsequent progression of iatrogenic immunodeficiency-associated lymphoproliferative disorders in patients with autoimmune diseases. Hematol Oncol, 38 : 799-807, 2020 (PMID : 32798315)
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14) Tokuhira M, et al : The clinical impact of absolute lymphocyte count in peripheral blood among patients with methotrexate-associated lymphoproliferative disorders. J Clin Exp Hematop, 60 : 41-50, 2020 (PMID : 32404570)
15) Takanashi S, et al : Clinical characteristics of methotrexate-associated lymphoproliferative disorders : relationship between absolute lymphocyte count recovery and spontaneous regression. Rheumatol Int, 37 : 1629-1633, 2017 (PMID : 28676912)
16) Saito S, et al : Restoration of Decreased T Helper 1 and CD8+ T Cell Subsets Is Associated With Regression of Lymphoproliferative Disorders Developed During Methotrexate Treatment. Front Immunol, 9 : 621, 2018 (PMID : 29670617)
17) Hashimoto A, et al : Incidence of malignancy and the risk of lymphoma in Japanese patients with rheumatoid arthritis compared to the general population. J Rheumatol, 42 : 564-571, 2015 (PMID : 25593236)
18) 第II章 リンパ腫 悪性リンパ腫総論. 「造血器腫瘍診療ガイドライン 2018年版補訂版」 (日本血液学会/編), 金原出版, 2020
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24) Satou A, et al : Methotrexate-associated lymphoproliferative disorders of T-cell phenotype : clinicopathological analysis of 28 cases. Mod Pathol, 32 : 1135-1146, 2019 (PMID : 30952973)
25) Saito R, et al : Overall survival and post-spontaneous regression relapse-free survival of patients with lymphoproliferative disorders associated with rheumatoid arthritis : a multi-center retrospective cohort study. Mod Rheumatol, 32 : 50-58, 2022 (PMID : 33336615)

10 リンパ増殖性疾患が疑われる関節リウマチ患者への血液内科医の対応と代表的病理組織型別治療

P.124 掲載の参考文献
1) Kuramoto N, et al : Characteristics of rheumatoid arthritis with immunodeficiency-associated lymphoproliferative disorders to regress spontaneously by the withdrawal of methotrexate and their clinical course : A retrospective, multicenter, case-control study. Mod Rheumatol, 32 : 24-31, 2022 (PMID : 33496194)
2) Hoshida Y, et al : Lymphoproliferative disorders in autoimmune diseases in Japan : analysis of clinicopathological features and Epstein-Barr virus infection. Int J Cancer, 108 : 443-449, 2004 (PMID : 14648712)
3) Kojima M, et al : Methtrexate-associated lymphoproliferative disorders. A clinicopathological study of 13 Japanese cases. Pathol Res Pract, 202 : 679-685, 2006 (PMID : 16859835)
4) Miyazaki T, et al : Remission of lymphoma after withdrawal of methotrexate in rheumatoid arthritis : relationship with type of latent Epstein-Barr virus infection. Am J Hematol, 82 : 1106-1109, 2007 (PMID : 17654684)
5) Niitsu N, et al : Clinicopathologic correlations of diffuse large B-cell lymphoma in rheumatoid arthritis patients treated with methotrexate. Cancer Sci, 101 : 1309-1313, 2010 (PMID : 20210795)
6) Tokuhira M, et al : Clinicopathological analyses in patients with other iatrogenic immunodeficiency-associated lymphoproliferative diseases and rheumatoid arthritis. Leuk Lymphoma, 53 : 616-623, 2012 (PMID : 21933041)
7) Ichikawa A, et al : Methotrexate/iatrogenic lymphoproliferative disorders in rheumatoid arthritis : histology, Epstein-Barr virus, and clonality are important predictors of disease progression and regression. Eur J Haematol, 91 : 20-28, 2013 (PMID : 23560463)
8) Gion Y, et al : Clinicopathological analysis of methotrexate-associated lymphoproliferative disorders : Comparison of diffuse large B-cell lymphoma and classical Hodgkin lymphoma types. Cancer Sci, 108 : 1271-1280, 2017 (PMID : 28380678)
9) Tokuhira M, et al : Clinicopathologic investigation of methotrexate-induced lymphoproliferative disorders, with a focus on regression. Leuk Lymphoma, 59 : 1143-1152, 2018 (PMID : 28877615)
10) Kurita D, et al : Methotrexate-associated Lymphoproliferative Disorders in Patients With Rheumatoid Arthritis : Clinicopathologic Features and Prognostic Factors. Am J Surg Pathol, 43 : 869-884, 2019 (PMID : 31116708)
11) Tokuhira M, et al : Clinical management for other iatrogenic immunodeficiency-associated lymphoproliferative disorders. J Clin Exp Hematop, 59 : 72-92, 2019 (PMID : 31257348)
12) Inui Y, et al : Methotrexate-associated lymphoproliferative disorders : management by watchful waiting and observation of early lymphocyte recovery after methotrexate withdrawal. Leuk Lymphoma, 56 : 3045-3051, 2015 (PMID : 25721751)
13) Saito R, et al : Overall survival and post-spontaneous regression relapse-free survival of patients with lymphoproliferative disorders associated with rheumatoid arthritis : a multi-center retrospective cohort study. Mod Rheumatol, 32 : 50-58, 2022 (PMID : 33336615)
14) Saito S, et al : Distinct patterns of lymphocyte count transition in lymphoproliferative disorder in patients with rheumatoid arthritis treated with methotrexate. Rheumatology (Oxford), 56 : 940-946, 2017 (PMID : 28165538)
15) Saito S, et al : Restoration of Decreased T Helper 1 and CD8+ T Cell Subsets Is Associated With Regression of Lymphoproliferative Disorders Developed During Methotrexate Treatment. Front Immunol, 9 : 621, 2018 (PMID : 29670617)
16) Takanashi S, et al : Clinical characteristics of methotrexate-associated lymphoproliferative disorders : relationship between absolute lymphocyte count recovery and spontaneous regression. Rheumatol Int, 37 : 1629-1633, 2017 (PMID : 28676912)
17) Tokuhira M, et al : The clinical impact of absolute lymphocyte count in peripheral blood among patients with methotrexate - associated lymphoproliferative disorders. J Clin Exp Hematop, 60 : 41-50, 2020 (PMID : 32404570)
18) Tokuhira M, et al : Clinicopathological features of clinical methotrexate-related lymphoproliferative disorders. Leuk Lymphoma, 60 : 2508-2515, 2019 (PMID : 30947579)
19) Gaulard P, et al : 16 Immunodeficiency-associated lymphoproliferative disorders.「WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues, Revised 4th Edition」 (Swerdlow SH, et al, eds), pp443-464, IARC Press, 2017
20) C arreras J, et al : Genomic Profile and Pathologic Features of Diffuse Large B-Cell Lymphoma Subtype of Methotrexate-associated Lymphoproliferative Disorder in Rheumatoid Arthritis Patients. Am J Surg Pathol, 42 : 936-950, 2018 (PMID : 29738359)
21) Kaji D, et al : Retrospective analyses of other iatrogenic immunodeficiency-associated lymphoproliferative disorders in patients with rheumatic diseases. Br J Haematol, 195 : 585-594, 2021 (PMID : 34558064)
22) 第II章 リンパ腫悪性リンパ腫総論. 「造血器腫瘍診療ガイドライン 2018年版補訂版」 (日本血液学会/編), 金原出版, 2020
23) 第II章 リンパ腫 5 びまん性大細胞型B 細胞リンパ腫. 「造血器腫瘍診療ガイドライン 2018年版補訂版」 (日本血液学会/編), 金原出版, 2020
24) 第II章 リンパ腫 10 ホジキンリンパ腫. 「造血器腫瘍診療ガイドライン 2018年版補訂版」 (日本血液学会/編), 金原出版, 2020
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27) Connors JM, et al : Brentuximab Vedotin with Chemotherapy for Stage III or IV Hodgkin's Lymphoma. N Engl J Med, 378 : 331-344, 2018 (PMID : 29224502)
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11 リンパ腫 / リンパ増殖性疾患の消退 / 寛解後の関節リウマチ治療 ( 推奨される薬剤 )

P.133 掲載の参考文献
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2) Singh JA, et al : 2015 American College of Rheumatology Guideline for the Treatment of Rheumatoid Arthritis. Arthritis Rheumatol, 68 : 1-26, 2016 (PMID : 26545940)
3) Nakano K, et al : Treatment of rheumatoid arthritis after regression of lymphoproliferative disorders in patients treated with methotrexate : a retrospective, multi-center descriptive study. Mod Rheumatol, 32 : 41-49, 2022 (PMID : 33164614)
4) 中野和久 : MTX治療中のRA患者に発生したリンパ増殖性疾患消退後のRA治療. リウマチ科, 66 : 379-386, 2021
5) Hashimoto A, et al : Incidence of malignancy and the risk of lymphoma in Japanese patients with rheumatoid arthritis compared to the general population. J Rheumatol, 42 : 564-571, 2015 (PMID : 25593236)
6) リウマトレックス(R) 適正使用情報 vol.24. ファイザー株式会社, 2018.5
7) Gaulard P, et al : International Agency for Research on Cancer : Other iatrogenic immunodeficiency-associated lymphoproliferative disorders.「WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues, 4th Edition」 (Swerdlow SH, et al, eds), pp350-351, IARC Press, 2008
8) リウマトレックス(R) 適正使用情報 vol.27. ファイザー株式会社, 2021.6
9) Tokuhira M, et al : Clinical management for other iatrogenic immunodeficiency-associated lymphoproliferative disorders. J Clin Exp Hematop, 59 : 72-92, 2019 (PMID : 31257348)
10) Nakano K, et al : Clinical aspects in patients with rheumatoid arthritis complicated with lymphoproliferative disorders without regression after methotrexate withdrawal and treatment for arthritis after regression of lymphoproliferative disorders. Mod Rheumatol, 31 : 94-100, 2021 (PMID : 32159414)
11) Hashwah H, et al : The IL-6 signaling complex is a critical driver, negative prognostic factor, and therapeutic target in diffuse large B-cell lymphoma. EMBO Mol Med, 11 : e10576, 2019 (PMID : 31515941)
12) Maneiro JR, et al : Risks of malignancies related to tofacitinib and biological drugs in rheumatoid arthritis : Systematic review, meta-analysis, and network meta-analysis. Semin Arthritis Rheum, 47 : 149-156, 2017 (PMID : 28284845)
13) ゼルヤンツ(R) 錠適正使用情報 vol.12. 関節リウマチに対する特定使用成績調査 (全例調査) の中間報告. ファイザー株式会社, 2019.3
14) Katsuyama T, et al : Prognostic factors of methotrexate-associated lymphoproliferative disorders associated with rheumatoid arthritis and plausible application of biological agents. Mod Rheumatol, 27 : 773-777, 2017 (PMID : 27846761)
15) 鈴木康夫, 他 : 関節リウマチ関連リンパ増殖性疾患の診断と管理. 『令和2年度厚生労働行政推進調査事業費補助金 (免疫・アレルギー疾患政策研究事業) 「我が国の関節リウマチ診療の標準化に関する臨床疫学研究」 (H30-免疫-指定-002) 分担研究報告書』, 2021 https://mhlw-grants.niph.go.jp/system/files/report_pdf/202013002A%20--buntan2_0.pdf (2022年3月閲覧)

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