A Case with T-Cell Large Granular Lymphocyte Leukemia Accompanied with Persistent neutropenia without Anemia and Thrombocytopenia

Ji-Hua Jon; Hye-Song Kim; Gwang-Il Kim

Abstract

AbstractWe report a case of T-cell large granular lymphocyte (T-LGL) leukemia accompanied with persistent neutropenia without anemia and thrombocytopenia. A 47-year-old man was diagnosed as T-cell large granular lymphocyte leukemia by clinical feature, a persistent increase in the number of peripheral blood large granular lymphocyte and immune his to chemical analysis. He had the recurrent aphthous stomatitis persisting for more than 1 year. He showed neither lymph node swelling and no accompanied with any autoimmune diseases including rheumatoid arthritis. Lymphocyte count was markedly increased (81%) and neutrophil count decreased (7%) on the peripheral blood smear. Flow cytometric analysis showed that lymphoid cells in the peripheral blood were positive for CD3 (98%), CD5 (96%), CD8 (90%) and negative for CD10 (1%), CD19 (2%), CD20 (3%), CD23 (1%), CD56 (1%) respectively. Because of severe neutropenia, we treated the patient with cyclosporine (300 mg per day for 3 months) with a transient improvement in hematological values, but 3 months after discontinuance of cyclosporine administration, the absolute lymphocyte count and neutrophils count were returned to pretreatment level respectively (lymphocyte 84%, neutrophil 13%). Cyclosporine treatment was immediately restarted with the regulation of dosage according to degree of lymphcytosis and neutropenia, and within 9 months hematologic values normalized. In conclusion, cyclosporine was effective in the treatment of T-cell large granular lymphocyte (T-LGL) leukemia accompanied with persistent neutropenia without anemia and thrombocytopenia and the dosage should be regulated according to the degree of lymphcytosis and neutropenia. Keywords: Cyclosporine, Lymphocytosis, neutropenia, T-cell large granular lymphocyte (T-LGL) leukemiaCite this ArticleJi-Hua Jon, Hye-Song Kim, So-Mi Jon. A Case with T-Cell Large Granular Lymphocyte Leukemia Accompanied with Persistent neutropenia without Anemia and Thrombocytopenia. Research & Reviews: Journal of Oncology and Hematology. 2020; 9(2): 24–28p.