Pathophysiology of methotrexate-related lymphoproliferative disorders

2021 Fiscal Year Final Research Report

• Project/Area Number: 19K16586
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 49020:Human pathology-related
• Research Institution: Ehime Prefectural University of Health Science (2021); Okayama University (2019-2020)
• Principal Investigator: Gion Yuka 愛媛県立医療技術大学, 保健科学部, 准教授 (50832979)
• Project Period (FY): 2019-04-01 – 2022-03-31
• Keywords: リンパ増殖性疾患 / 悪性リンパ腫 / PD-L1

Outline of Final Research Achievements

This three-year research plan addressed two research topics: "Lymphocyte subset variation in peripheral blood before and after MTX administration" and "PD-L1 expression in MTX-LPD".
The case collection and data analysis of "Lymphocyte subset changes in peripheral blood before and after MTX administration" are still ongoing, and although we have not yet published a scientific paper, we made a presentation at the 61st Annual Meeting of the Japanese Society for Lymphoreticular Tissue Research.
Regarding "PD-L1 expression in MTX-LPD", we reported in the Scientific Journal (Cancer medicine)that PD-L1 expression in tumor cells may be related to one of the reasons why CHL-type MTX-LPD does not spontaneously remit after MTX discontinuation.

Free Research Field

病理

Academic Significance and Societal Importance of the Research Achievements

MTX-LPDはDLBCL-typeとCHL-type、いずれかの組織像を示す症例が大部分を占める。約3割の患者ではMTX休薬のみで自然消褪することが知られているが、CHL-typeでは自然消褪せず、増悪・再燃を来す症例が多い。その原因として、我々はCHL-type MTX-LPDの腫瘍細胞PD-L1が関与していることを報告した。PD-L1が強発現している症例では、MTX休薬後も増悪・再燃を来しやすいことが示唆され、より慎重なフォローアップが必要であることを報告した。
この報告は、CHL-type MTX-LPD診断時の一助となり得るかもしれない。