Successful allogeneic peripheral blood stem cell transplantation for an aggressive variant of T-cell large granular-lymphocyte leukemia: A case report

Authors: Kazuhito Suzuki, Kaichi Nishiwaki, Jiro Minami, Hidekazu Masuoka, Mitsuji Katori, Hiroki Yokoyama, Hideki Uryu, Shingo Yano

first published: October, 26. 2018

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DOI: https://doi.org/10.31547/bct-2018-006

Vol.2 Issue 1 No.2 2019 / BCT-2018-006

Abstract

The aggressive variant of large granular lymphocyte (LGL) leukemia is very rare and the prognosis of this disease is poor. A 47-year-old woman with progressive pancytopenia and severe liver damage visited our institute. Upon hospitalization, about 30% LGL was detected in her peripheral blood and bone marrow samples. Flow cytometry was conducted to analyze lymphocytes in the bone marrow, which revealed the presence of CD3 and T-cell receptor (TCR) α/β and absence of CD4, CD8, CD16, CD56, CD22, CD79a, and terminal deoxynucleotidyl transferase (TdT). Southern blotting was performed, which revealed the presence of rearrangement of TCR-Cβ1 and Jγ. We made a diagnosis of the aggressive variant of T-LGL leukemia, and performed myeloablative allogeneic peripheral stem cell transplantation (allo-HSCT) from an HLA-matched sibling for primary refractory disease of CHOP and hyper CVAD therapy. She is alive in remission with donor-derived T-LGL lymphocytosis in peripheral blood for 7 years after allo-HSCT. Overall, Allo-HSCT could be active against the aggressive variant of LGL leukemia and induce graft-versus-leukemia effect.

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Supplementary Materials : none

 

Authors

Kazuhito Suzuki1,2, Kaichi Nishiwaki1,2, Jiro Minami2,  Hidekazu Masuoka1,2, Mitsuji Katori1,2, Hiroki Yokoyama1,2, Hideki Uryu1,2, Shingo Yano2

1: Division of Clinical Oncology/Hematology, The Jikei University Kashiwa Hospital, Chiba, Japan

2: Division of Clinical Oncology/Hematology, The Jikei University School of Medicine, Tokyo, Japan

 

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