HEMATOLOGIC MALIGNANCIES AND THE USE OF METHOTREXATE IN RHEUMATOID-ARTHRITIS - A RETROSPECTIVE STUDY

PURPOSE: To evaluate the relationship between use of methotrexate in r heumatoid arthritis patients and development of hematologic malignanci es. PATIENTS AND METHODS: We retrospectively analyzed all patients reg istered at the Mayo Clinic from 1976 through 1992 with rheumatoid arth ritis (n = 16,263) cross-indexed with patients registered during the s ame period with a hematologic malignancy (n = 21,270). Adult patients were selected who had rheumatoid arthritis, were treated with a diseas e-modifying antirheumatic drug, and subsequently developed a hematolog ic malignancy. RESULTS: Thirty-nine patients met the selection criteri a. Twelve of them had been given methotrexate. The characteristics of those who received methotrexate, including the type of hematologic mal ignancy, did not differ from those of patients who received other dise ase-modifying antirheumatic drugs. CONCLUSIONS: Hematologic malignanci es are uncommon in patients with rheumatoid arthritis treated with dis ease-modifying antirheumatic drugs, including methotrexate. There does not appear to be a relationship between the peak or cumulative dose o r the duration of methotrexate therapy and the subsequent development of hematologic malignancy, The histologic types of hematologic maligna ncy seen in the methotrexate-treated patients did not differ from thos e of patients treated with other disease-modifying antirheumatic drugs .