BACKGROUND: Lymphocyte expansion and true lymphocytosis are commonly observed in the everyday clinical practice. The meaning of such phenomenon is often poorly understood so that discrimination between benign and malignant lymphocytosis remains difficult to establish. This is mainly true when lymphocytosis rises in patients affected by immune-mediated chronic inflammatory diseases under immunosuppressive treatment, conditions potentially associated with lymphomagenesis. In this brief report the development of mild T CD4pos lymphocytosis in a group of patients with chronic arthritis under anti-TNF-α treatment is described. METHODS: Two hundred eight rheumatoid arthritis (RA) and psoriatic arthritis (PsA) patients have been evaluated longitudinally for at least 1-year before and 2-years after anti-TNF-α therapy introduction for the possible appearance of a lymphocyte expansion. In patients who developed lymphocyte expansion, T, B and NK cells were analysed. RESULTS: Twenty-five out of 208 (12%) subjects developed a mild T CD4pos lymphocytosis, during anti-TNF-α therapy, which reverted after its interruption. Higher lymphocyte count, more frequent use of steroids and shorter disease duration, before biological therapy start, have emerged as risk factors for lymphocytosis development. CONCLUSIONS: This is the first longitudinal cohort study evaluating the onset of lymphocytosis in RA and PsA patients under anti-TNF-α treatment and its possible clinical relevance. A mild T CD4pos lymphocytosis has been observed in 12% of RA and PsA patients probably related to anti-TNF-α treatment as previously reported by anecdotal cases. Patients with higher baseline lymphocyte count, use of steroids and shorter disease duration before the introduction of biologic therapy, seem to be prone to develop this laboratory reversible abnormality.

TCD4pos lymphocytosis in rheumatoid and psoriatic arthritis patients following TNFα blocking agents / PICCHIANTI DIAMANTI, Andrea; Lagana', Bruno; Cox, Maria Christina; Pilozzi, Emanuela; Amodeo, Rachele; Bove, Maurizio; Markovic, Milica; DI ROSA, Roberta; Salemi, Simonetta; Sorgi, Maria Laura; Rosado, Maria Manuela; D'Amelio, Raffaele. - In: JOURNAL OF TRANSLATIONAL MEDICINE. - ISSN 1479-5876. - STAMPA. - 15:1(2017), pp. 1-6. [10.1186/s12967-017-1135-6]

TCD4pos lymphocytosis in rheumatoid and psoriatic arthritis patients following TNFα blocking agents

PICCHIANTI DIAMANTI, Andrea
Co-primo
Writing – Original Draft Preparation
;
LAGANA', Bruno
Co-primo
Writing – Original Draft Preparation
;
PILOZZI, Emanuela;BOVE, MAURIZIO;DI ROSA, Roberta;SORGI, Maria Laura;D'AMELIO, Raffaele
2017

Abstract

BACKGROUND: Lymphocyte expansion and true lymphocytosis are commonly observed in the everyday clinical practice. The meaning of such phenomenon is often poorly understood so that discrimination between benign and malignant lymphocytosis remains difficult to establish. This is mainly true when lymphocytosis rises in patients affected by immune-mediated chronic inflammatory diseases under immunosuppressive treatment, conditions potentially associated with lymphomagenesis. In this brief report the development of mild T CD4pos lymphocytosis in a group of patients with chronic arthritis under anti-TNF-α treatment is described. METHODS: Two hundred eight rheumatoid arthritis (RA) and psoriatic arthritis (PsA) patients have been evaluated longitudinally for at least 1-year before and 2-years after anti-TNF-α therapy introduction for the possible appearance of a lymphocyte expansion. In patients who developed lymphocyte expansion, T, B and NK cells were analysed. RESULTS: Twenty-five out of 208 (12%) subjects developed a mild T CD4pos lymphocytosis, during anti-TNF-α therapy, which reverted after its interruption. Higher lymphocyte count, more frequent use of steroids and shorter disease duration, before biological therapy start, have emerged as risk factors for lymphocytosis development. CONCLUSIONS: This is the first longitudinal cohort study evaluating the onset of lymphocytosis in RA and PsA patients under anti-TNF-α treatment and its possible clinical relevance. A mild T CD4pos lymphocytosis has been observed in 12% of RA and PsA patients probably related to anti-TNF-α treatment as previously reported by anecdotal cases. Patients with higher baseline lymphocyte count, use of steroids and shorter disease duration before the introduction of biologic therapy, seem to be prone to develop this laboratory reversible abnormality.
2017
anti-tnf-α agent; lymphocytosis; psoriatic arthritis; rheumatoid arthritis; tcr; medicine (all); biochemistry; genetics and molecular biology (all)
01 Pubblicazione su rivista::01a Articolo in rivista
TCD4pos lymphocytosis in rheumatoid and psoriatic arthritis patients following TNFα blocking agents / PICCHIANTI DIAMANTI, Andrea; Lagana', Bruno; Cox, Maria Christina; Pilozzi, Emanuela; Amodeo, Rachele; Bove, Maurizio; Markovic, Milica; DI ROSA, Roberta; Salemi, Simonetta; Sorgi, Maria Laura; Rosado, Maria Manuela; D'Amelio, Raffaele. - In: JOURNAL OF TRANSLATIONAL MEDICINE. - ISSN 1479-5876. - STAMPA. - 15:1(2017), pp. 1-6. [10.1186/s12967-017-1135-6]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/949714
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