Acute myeloid leukemia in the setting of low dose weekly methotrexate therapy for rheumatoid arthritis

B. Kolte, A. N. Baer, S. N.J. Sait, K. L. O'Loughlin, C. C. Stewart, M. Barcos, M. Wetzler, M. R. Baer

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


Methotrexate is in widespread use as second-line therapy for rheumatoid arthritis. Treatment with methotrexate in this and other settings has not been associated with the development of therapy-related leukemias. Four patients with rheumatoid arthritis are reported who developed acute myeloid leukemia (AML) while receiving low dose weekly methotrexate therapy in the absence of previous or concomitant treatment with known leukemogenic agents. AML in these four patients was of different morphologic subtypes and was associated with heterogeneous cytogenetic abnormalities, cell surface marker expression and multidrug resistance protein expression. None of the recognized features of therapy-related leukemia were present in these four nor in five previously-reported patients. It is likely that the occurrence of AML in patients with rheumatoid arthritis in the setting of methotrexate therapy represents the coincidence of these two diseases, and does not reflect a causal relationship.

Original languageEnglish (US)
Pages (from-to)371-378
Number of pages8
JournalLeukemia and Lymphoma
Issue number3
StatePublished - Jan 1 2001
Externally publishedYes


  • Acute myeloid leukemia
  • Methotrexate
  • Rheumatoid arthritis
  • Trisomy 13

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research


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