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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S17) Migita K, et al : Epstein-Barr virus and methotrexate-related CNS lymphoma in a patient with rheumatoid arthritis. Mod Rheumatol, 23 : 832-836, 2013 (PMID : 22825547)
 
S18) Fujimoto M, et al : Coexistence of Epstein-Barr virus-associated lymphoproliferative disorder and marginal zone B-cell lymphoma of the thymus in a patient with rheumatoid arthritis treated with methotrexate. Histopathology, 61 : 1230-1232, 2012 (PMID : 22958131)
 
S19) Takemori N, et al : Complete Remission of Methotrexate-Related Epstein-Barr-Virus-Associated Hodgkin-Like Lymphoma following Withdrawal of MTX Coupled with Clarithromycin Administration. Case Rep Hematol, 2012 : 658745, 2012 (PMID : 23316401)
 
S20) Kawano N, et al : Successful treatment of immunodeficiency-associated EBV-negative lymphoproliferative disorders in rheumatoid arthritis by methotrexate withdrawal and prevention of its relapse by rituximab administration. J Clin Exp Hematop, 52 : 193-198, 2012 (PMID : 23269079)
 
S21) Kobayashi S, et al : Reversible iatrogenic, MTX-associated EBV-driven lymphoproliferation with histopathological features of a lymphomatoid granulomatosis in a patient with rheumatoid arthritis. Ann Hematol, 92 : 1561-1564, 2013 (PMID : 23529185)
 
S22) Fukushima M, et al : Primary central nervous system malignant lymphoma in a patient with rheumatoid arthritis receiving low-dose methotrexate treatment. Br J Neurosurg, 27 : 824-826, 2013 (PMID : 23705580)
 
S23) Fujita T, et al : Multi-modality imaging findings of methotrexate-related Epstein-Barr virus-associated hepatic tumor. Clin Imaging, 37 : 962-964, 2013 (PMID : 23849101)
 
S24) Ochi N, et al : Methotrexate-induced lymphoproliferative disease : Epstein-Barr virus-associated lymphomatoid granulomatosis. J Clin Oncol, 31 : e348-e350, 2013 (PMID : 23733760)
 
S25) Ishida M, et al : Methotrexate-related Epstein-Barr virus-associated lymphoproliferative disorder occurring in the gingiva of a patient with rheumatoid arthritis. Int J Clin Exp Pathol, 6 : 2237-2241, 2013 (PMID : 24133604)
 
S26) 兼 順, 他 : 関節リウマチに対しMethotrexate継続治療9年目に発生した医原性免疫不全リンパ増殖性疾患において投薬中止にて自然緩解が得られた1例. 癌と化学療法, 40 : 2454-2456, 2013
 
S27) Hanakawa H, et al : Large ulceration of the oropharynx induced by methotrexate-associated lymphoproliferative disorders. Acta Med Okayama, 67 : 265-269, 2013 (PMID : 23970326)
 
S28) 山川知宏, 他 : メトトレキサート中止と脳病変への放射線照射が奏効したメトトレキサート関連リンパ腫様肉芽腫症. 臨床血液, 55 : 321-326, 2014
 
S29) Horie N, et al : Methotrexate-related lymphoproliferative disorder arising in the gingiva of a patient with rheumatoid arthritis. Aust Dent J, 60 : 408-411, 2015 (PMID : 25302816)
 
S30) Oiwa H, et al : Grade 3 lymphomatoid granulomatosis in a patient receiving methotrexate therapy for rheumatoid arthritis. Intern Med, 53 : 1873-1875, 2014 (PMID : 25130128)
 
S31) Tatsumi G, et al : Primary hepatic lymphoma in a patient with rheumatoid arthritis treated with methotrexate. Case Rep Hematol, 2014 : 460574, 2014 (PMID : 25610674)
 
S32) Tokuyama K, et al : EBV-positive MTX-diffuse large B cell lymphoma in a rheumatoid arthritis patient. Jpn J Radiol, 32 : 183-187, 2014 (PMID : 24408079)
 
S33) Kuroda T, et al : Effects of a biologic agent in a patient with rheumatoid arthritis after treatment for methotrexate-associated B-cell lymphoma : a case report. BMC Res Notes, 7 : 229, 2014 (PMID : 24721419)
 
S34) Matsumoto Y, et al : Rheumatoid arthritis/methotrexate-associated primary cutaneous diffuse large B-cell lymphoma, leg type. Intern Med, 53 : 1177-1181, 2014 (PMID : 24881744)
 
S35) 高住美香, 他 : 肝腫瘍生検にて診断が得られたMTX関連リンパ増殖性疾患の1例. 日本消化器病学会雑誌, 112 : 115-122, 2015
 
S36) Shimada H, et al : Primary central nervous system lymphoma in a rheumatoid arthritis patient treated with methotrexate : a case report. BMC Res Notes, 8 : 88, 2015 (PMID : 25888766)
 
S37) Kawahara A, et al : Reversible methotrexate-associated lymphoma of the liver in rheumatoid arthritis : a unique case of primary hepatic lymphoma. Biomark Res, 3 : 10, 2015 (PMID : 25964853)
 
S38) Ohkura Y, et al : Primary Adrenal Lymphoma Possibly Associated With Epstein-Barr Virus Reactivation Due to Immunosuppression Under Methotrexate Therapy. Medicine (Baltimore), 94 : e1270, 2015 (PMID : 26252293)
 
S39) Abe A, et al : A case of rheumatoid arthritis with methotrexate related lymphoproliferative diseases of the knee. Mod Rheumatol, 28 : 550-554, 2018 (PMID : 26558294)
 
S40) Tajima S, et al : Methotrexate-associated lymphoproliferative disorder presenting as extranodal NK/T-cell lymphoma arising in the lungs. Pathol Int, 65 : 661-665, 2015 (PMID : 26459854)
 
S41) Miyagawa K, et al : Methotrexate-related primary hepatic lymphoma in a patient with rheumatoid arthritis. Intern Med, 54 : 401-405, 2015 (PMID : 25748956)
 
S42) Ureshino H, et al : Spontaneous Regression of Methotrexate-related Lymphoproliferative Disorder with T-cell Large Granular Lymphocytosis. Intern Med, 54 : 2235-2239, 2015 (PMID : 26328653)
 
S43) 深澤雅彦, 他 : 医原性リンパ増殖性疾患の4症例. 日本耳鼻咽喉科学会会報, 119 : 741-749, 2016
 
S44) 葛城武文, 他 : 関節リウマチに対する長期methotrexate投与中に発症した免疫不全関連Burkittリンパ腫. 臨床血液, 57 : 9-14, 2016
 
S45) Takei D, et al : Methotrexate-associated primary hepatic malignant lymphoma following hepatectomy : A case report. Int J Surg Case Rep, 31 : 5-9, 2017 (PMID : 28076752)
 
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S47) Kobayashi Y, et al : Methotrexate-associated orbital lymphoproliferative disorder in a patient with rheumatoid arthritis : a case report. Jpn J Ophthalmol, 60 : 212-218, 2016 (PMID : 27018050)
 
S48) Kikuchi J, et al : Methotrexate-associated Intravascular Large B-cell Lymphoma in a Patient with Rheumatoid Arthritis. Intern Med, 55 : 1661-1665, 2016 (PMID : 27301524)
 
S49) Matsumoto R, et al : A case of multiple hepatic lesions associated with methotrexate-associated lymphoproliferative disorder. J Med Ultrason (2001), 43 : 545-551, 2016 (PMID : 27577564)
 
S50) Kurimoto R, et al : MYC/BCL2 Double-hit Lymphoma in a Patient with Rheumatoid Arthritis Associated with Methotrexate Treatment. Intern Med, 55 : 2271-2275, 2016 (PMID : 27523007)
 
S51) Ishiguro K, et al : Other Iatrogenic Immunodeficiency-associated Lymphoproliferative Disorder Presenting as Primary Bone Lymphoma in a Patient with Rheumatoid Arthritis. Intern Med, 55 : 2259-2264, 2016 (PMID : 27523005)
 
S52) Kida T, et al : Intravascular lymphoma in a rheumatoid arthritis patient following short-term methotrexate treatment. Rheumatology (Oxford), 56 : 318-320, 2017 (PMID : 27818387)
 
S53) Tsukazaki Y, et al : Hepatosplenic Hodgkin lymphoma without lymphadenopathy following reversible methotrexate-associated lymphoproliferative disorder. Mod Rheumatol, 27 : 372-375, 2017 (PMID : 25401225)
 
S54) Tokuhira M, et al : The aggressive clinical courses of Hodgkin lymphoma primarily diagnosed as methotrexate-induced non-specific lymphoproliferative disorder in patients with rheumatoid arthritis. J Clin Exp Hematop, 56 : 165-169, 2017 (PMID : 28331131)
 
S55) 青田泰雄, 他 : 腸管穿孔を契機に診断に至ったメトトレキサート関連リンパ増殖性疾患 (met hotrexate-associated lymphoproliferative disorder : MTX-LPD). 日本老年医学会雑誌, 54 : 567-572, 2017
 
S56) 北風宏明, 他 : CTガイド下生検およびMTX投与歴からMTX関連リンパ増殖性疾患と診断しえた両側副腎偶発腫瘍の1例. 泌尿器科紀要, 63 : 201-206, 2017
 
S57) 内田智之, 他 : 抗リウマチ薬投与中に発症した医原性免疫不全関連EBV陰性NK細胞性リンパ増殖性疾患. 臨床血液, 58 : 624-629, 2017
 
S58) Saburi M, et al : Other Iatrogenic Immunodeficiency-associated Lymphoproliferative Disorder, Hodgkin Type, following Epstein-Barr Viral Hepatitis in a Patient with Rheumatoid Arthritis. Intern Med, 57 : 1145-1149, 2018 (PMID : 29279493)
 
S59) Furukawa S, et al : Oral Methotrexate-related Lymphoproliferative Disease Presenting with Severe Osteonecrosis of the Jaw : A Case Report and Literature Review. Intern Med, 57 : 575-581, 2018 (PMID : 29225245)
 
S60) Oebisu N, et al : Lymphoproliferative disorder with pathological fracture of the femur in a patient with rheumatoid arthritis treated with methotrexate : A case report. Mol Clin Oncol, 9 : 187-191, 2018 (PMID : 30101019)
 
S61) Suzuki E, et al : Methotrexate-associated lymphoproliferative disorder complicated by severe acute respiratory failure and ileal perforation : a case report. Fukushima J Med Sci, 64 : 82-88, 2018 (PMID : 29925726)
 
S62) Aiko N, et al : The Spontaneous Regression of Grade 3 Methotrexate-related Lymphomatoid Granulomatosis : A Case Report and Literature Review. Intern Med, 57 : 3163-3167, 2018 (PMID : 29877270)
 
S63) Watanabe H, et al : A surgical case of methotrexate-associated lymphomatoid granuloma. Gen Thorac Cardiovasc Surg, 66 : 435-438, 2018 (PMID : 29255968)
 
S64) 内田雄大, 他 : 関節リウマチに合併した中枢神経原発のメトトレキサート関連リンパ増殖性疾患の1例. 臨床神経学, 58 : 485-491, 2018
 
S65) Kikuchi N, et al : Methotrexate-related lymphoproliferative disorder of the lumbar spine origin presenting with severe low-back pain : case report. J Neurosurg Spine, 29 : 545-548, 2018 (PMID : 30168781)
 
S66) Kiyasu J, et al : Methotrexate-associated lymphoproliferative disorders with angioimmunoblastic T-cell lymphoma-like features accompanied by gamma-heavy chain disease in a patient with rheumatoid arthritis. Pathol Int, 68 : 485-490, 2018 (PMID : 29987858)
 
S67) Hashimoto K & Akagi M : Lymphoproliferative disorder in an elderly rheumatoid arthritis patient after longterm oral methotrexate administration : A case report. Mol Clin Oncol, 9 : 293-296, 2018 (PMID : 30155252)
 
S68) Ishigaki S, et al : Methotrexate-associated Lymphoproliferative Disorder of the Stomach Presumed to Be Mucosa-associated Lymphoid Tissue Lymphoma. Intern Med, 57 : 3249-3254, 2018 (PMID : 30429434)
 
S69) Matsubayashi RN, et al : Methotrexate (MTX) -associated malignant lymphoma of the bilateral breast : imaging features in comparison to other nipple-areolar tumors. Clin Imaging, 53 : 120-125, 2019 (PMID : 30340074)
 
S70) Mizuguchi S, et al : The potential usefulness of sputum cytology in the conclusive diagnosis of methotrexate-associated lymphoproliferative disorders : A case report. SAGE Open Med Case Rep, 7 : 2050313X19836017, 2019 (PMID : 30886720)
 
S71) Toyama S, et al : Gastric Perforation due to Iatrogenic Immunodeficiency-associated Lymphoproliferative Disorder during the Treatment of Rheumatoid Arthritis. Intern Med, 58 : 3331-3336, 2019 (PMID : 31327821)
 
S72) Nogi S, et al : Iatrogenic immunodeficiency-associated latent Epstein-Barr virus-related lymphomatoid granulomatosis initially presenting as unusual gynecological manifestations in a case of rheumatoid arthritis-a case report and review. Mod Rheumatol Case Rep, 3 : 5-9, 2019
 
S73) Fujimi A, et al : Primary cutaneous diffuse large B-cell lymphoma, leg type, in a patient with rheumatoid arthritis undergoing etanercept therapy. Mod Rheumatol Case Rep, 5 : 195-199, 2021 (PMID : 33238812)
 
S74) Moriya K, et al : Methotrexate-associated lymphoproliferative disorder demonstrating composite lymphoma of EBV-negative diffuse large B-cell lymphoma and EBV-positive mucocutaneous ulcer. J Clin Exp Hematop, 60 : 11-16, 2020 (PMID : 32224560)
 
S75) Sekiguchi Y, et al : Methotrexate-associated Hodgkin Lymphoma in a Patient with Rheumatoid Arthritis Successfully Treated with Brentuximab Vedotin in Combination with Doxorubicin, Vinblastine, and Dacarbazine (BV+AVD). Intern Med, 59 : 2165-2171, 2020 (PMID : 32461524
 

4 WHO分類 ( 病理学的分類 )

P.53 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
 
2) 「WHO血液腫瘍分類-WHO分類2017をうまく活用するために改訂版」 (直江知樹, 他/編), 医薬ジャーナル社, 2018
 
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
 
2) 「WHO血液腫瘍分類-WHO分類2017をうまく活用するために改訂版」 (直江知樹, 他/編), 医薬ジャーナル社, 2018
 
3) 「リンパ腫アトラス 第5版」 (中村栄男, 他/編), 文光堂, 2018
 
4) 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)
 
5) 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)
 
6) 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)
 
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)
 
8) 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. 『令和元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』, 2019 https://mhlw-grants.niph.go.jp/system/files/2019/192071/201913008A_upload/201913008A0005.pdf (2022年3月閲覧)
 
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) Hemminki K, et al : Cancer risk in hospitalized rheumatoid arthritis patients. Rheumatology (Oxford), 47 : 698-701, 2008 (PMID : 18378514)
 
11) Bernatsky S, et al : Non-Hodgkin's lymphoma--meta-analyses of the effects of corticosteroids and non-steroidal anti-inflammatories. Rheumatology (Oxford), 46 : 690-694, 2007 (PMID : 17148471)
 
12) Swerdlow SH, et al : The 2016 revision of the World Health Organization classification of lymphoid neoplasms. Blood, 127 : 2375-2390, 2016 (PMID : 26980727)
 

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

P.75 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)
 
4) 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)
 
5) Wolfe F & Michaud K : Lymphoma in rheumatoid arthritis : the effect of methotrexate and anti-tumor necrosis factor therapy in 18,572 patients. Arthritis Rheum, 50 : 1740-1751, 2004 (PMID : 15188349)
 
6) Hoshida Y, et al : Lymphoproliferative disorders in rheumatoid arthritis : clinicopathological analysis of 76 cases in relation to methotrexate medication. J Rheumatol, 34 : 322-331, 2007 (PMID : 17117491)
 
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) 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)
 
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) 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)
 
11) 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
 
12) 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)
 
13) Baecklund E, et al : Association of chronic inflammation, not its treatment, with increased lymphoma risk in rheumatoid arthritis. Arthritis Rheum, 54 : 692-701, 2006 (PMID : 16508929)
 
14) Wolfe F & Michaud K : The effect of methotrexate and anti-tumor necrosis factor therapy on the risk of lymphoma in rheumatoid arthritis in 19,562 patients during 89,710 person-years of observation. Arthritis Rheum, 56 : 1433-1439, 2007 (PMID : 17469100)
 
15) Shiroky JB, et al : Complications of immunosuppression associated with weekly low dose methotrexate. J Rheumatol, 18 : 1172-1175, 1991 (PMID : 1941818)
 
16) Kamel OW, et al : Brief report : reversible lymphomas associated with Epstein-Barr virus occurring during methotrexate therapy for rheumatoid arthritis and dermatomyositis. N Engl J Med, 328 : 1317-1321, 1993 (PMID : 8385742)
 
17) 「WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues, 4th Edition」 (Swerdlow SH, et al, eds), IARC Press, 2008
 
18) Rizzi R, et al : Spontaneous remission of "methotrexate-associated lymphoproliferative disorders" after discontinuation of immunosuppressive treatment for autoimmune disease. Review of the literature. Med Oncol, 26 : 1-9, 2009 (PMID : 18461290)
 
19) 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
 
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)
 
21) McAulay KA & Jarrett RF : Human leukocyte antigens and genetic susceptibility to lymphoma. Tissue Antigens, 86 : 98-113, 2015 (PMID : 26189878)
 
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)
 
24) Yamakawa N, et al : A clinical, pathological, and genetic characterization of methotrexate-associated lymphoproliferative disorders. J Rheumatol, 41 : 293-299, 2014 (PMID : 24334644)
 
25) Retamozo S, et al : Prognostic markers of lymphoma development in primary Sjogren syndrome. Lupus, 28 : 923-936, 2019 (PMID : 31215845)
 
26) 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)
 
27) 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)
 
28) Dlouhy I, et al : High serum levels of soluble interleukin-2 receptor (sIL2-R), interleukin-6 (IL-6) and tumor necrosis factor alpha (TNF) are associated with adverse clinical features and predict poor outcome in diffuse large B-cell lymphoma. Leuk Res, 59 : 20-25, 2017 (PMID : 28544905)
 

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)
 
4) 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)
 
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
1) 「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
 
2) 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)
 
3) 外山圭助 : 1. リンパ増殖性疾患の診断の手順. 日本内科学会雑誌, 83 : 890-894, 1994
 
4) 石澤賢一 : 日常診療と悪性リンパ腫. 日本内科学会雑誌, 110 : 1383-1385, 2021
 
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
 
P.92 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
 
2) 「WHO 血液腫瘍分類-WHO分類2017をうまく活用するために 改訂版」 (直江知樹, 他/編), 医薬ジャーナル社, 2018
 
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)
 
4) 「慢性活動性EBウイルス感染症とその類縁疾患の診療ガイドライン 2016」 (日本小児感染症学会/監), 診断と治療社, 2016
 
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)
 
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) 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)
 
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)
 
8) Hoshida Y, et al : Lymphoproliferative disorders in rheumatoid arthritis : clinicopathological analysis of 76 cases in relation to methotrexate medication. J Rheumatol, 34 : 322-331, 2007 (PMID : 17117491)
 
9) Harigai M : Lymphoproliferative disorders in patients with rheumatoid arthritis in the era of widespread use of methotrexate : A review of the literature and current perspective. Mod Rheumatol, 28 : 1-8, 2018 (PMID : 28758827)
 
10) 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)
 
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)
 
13) 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)
 
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
 
19) Shiraiwa S, et al : Clinicopathological evaluation of methotrexate-associated lymphoproliferative disorders with special focus on Epstein-Barr virus-positive mucocutaneous lesions. J Clin Exp Hematop, 60 : 159-168, 2020 (PMID : 33148934)
 
20) Yamada C, et al : Pathological assessment of the lymph node biopsies for lymphadenopathy in rheumatoid arthritis. Mod Rheumatol, 30 : 835-842, 2020 (PMID : 31571513)
 
21) Yamakawa N, et al : A clinical, pathological, and genetic characterization of methotrexate-associated lymphoproliferative disorders. J Rheumatol, 41 : 293-299, 2014 (PMID : 24334644)
 
22) Gaulard P, et al : 13 Mature B-cell neoplasms. EBV-positive mucocutaneous ulcer.「WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues, Revised 4th Edition」 (Swerdlow SH, et al, eds), pp307-308, IARC Press, 2017
 
23) Satou A, et al : Other Iatrogenic Immunodeficiency-Associated Lymphoproliferative Disorders with a T-or NK-cell phenotype. J Clin Exp Hematop, 59 : 56-63, 2019 (PMID : 31257346)
 
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
 
25) Ferme C, et al : Chemotherapy plus involved-field radiation in early-stage Hodgkin's disease. N Engl J Med, 357 : 1916-1927, 2007 (PMID : 17989384)
 
26) Engert A, et al : Reduced treatment intensity in patients with early-stage Hodgkin's lymphoma. N Engl J Med, 363 : 640-652, 2010 (PMID : 20818855)
 
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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30) Chen R, et al : Phase II Study of the Efficacy and Safety of Pembrolizumab for Relapsed/Refractory Classic Hodgkin Lymphoma. J Clin Oncol, 35 : 2125-2132, 2017 (PMID : 28441111)
 
31) Ichikawa S, et al : Successful treatment of methotrexate-associated classical Hodgkin lymphoma with brentuximab vedotin-combined chemotherapy : a case series. Int J Hematol, 111 : 667-672, 2020 (PMID : 31955346)
 
32) Eso Y, et al : Choledochoduodenal Fistula during Chemotherapy with Brentuximab Vedotin for Methotrexate-associated Lymphoproliferative Disorder. Intern Med, 57 : 2203-2207, 2018 (PMID : 29526961)
 
33) Tokuhira M, et al : The aggressive clinical courses of Hodgkin lymphoma primarily diagnosed as methotrexate-induced non-specific lymphoproliferative disorder in patients with rheumatoid arthritis. J Clin Exp Hematop, 56 : 165-169, 2017 (PMID : 28331131)
 

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
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) 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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