Journal of Cutaneous Medicine and Surgery
04/17/2002
By Mark Greener
Methotrexate may increase the risk that mycosis fungoides will transform into large cell lymphoma, but the link is currently unproven.
Although patients with mycosis fungoides can undergo transformation to large cell lymphoma, the risk factors are not well established. While advanced mycosis fungoides seems especially likely to transform, the rarity of mycosis fungoides means that roles played by other factors isn't known.
Against this background, researchers from Boston University School of Medicine and Tufts University School of Medicine, Boston, Massachusetts, United States, aimed to ascertain the role of methotrexate in the progression of mycosis fungoides to large cell lymphoma. The authors identified 134 patients with mycosis fungoides from their cutaneous lymphoma database.
Three of the 21 patients (14.3 percent) with mycosis fungoides who received methotrexate transformed to large cell lymphoma. However, only two of the 113 patients (1.8 percent) who did not receive methotrexate progressed. This difference in transformation rates reached statistical significance. The authors added that the difference in transformation rates remained significant after controlling for disease stage and sex. One patient that transformed showed identical dominant T-cell clones in the large cell lymphoma and other skin samples.
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