Induction of clinical remission in T-large granular lymphocyte leukemia with cyclosporin A, monitored by use of immunophenotyping with Vβ antibodies

Abstract

A 54-year-old woman presented with a severe autoimmune anemia, thrombocytopenia, neutropenia (Evans' syndrome), and CD8؉ lymphocytosis, without signs of lymphadenopathy or splenomegaly. A diagnosis of T cell large granular lymphocyte (T-LGL) leukemia was made, based on cytomorphology, the typical CD3

How I treat LGL leukemia

“…Overall, 31 of 55 patients (56%) responded to splenectomy. 12,13,59,[91][92][93][94] Only 3 series of more than 10 patients have been published. The last 2 series show disappointing results.…”

Molecular and flow cytometric analysis of the Vβ repertoire for clonality assessment in mature TCRαβ T-cell proliferations

“…1 Finally, a major advantage of flow cytometric V␤ analysis over PCR-based assays is that once established and confirmed, the V␤-restricted T-cell population can easily and quantitatively be monitored in combination with other markers during and after therapy, using age-dependent reference values for comparison. 10,41 …”

TCRγδ+ large granular lymphocyte leukemias reflect the spectrum of normal antigen-selected TCRγδ+ T-cells

“…As eradication of the malignant clone does not seem to be essential for disease control, effective immunomodulatory agents such as methotrexate and cyclosporine seem to be preferred over intensive cytotoxic regimens. [34][35][36][37] However, results of future international standardized treatment protocols should reveal the optimal therapeutic strategy for both TCRab þ and TCRgd þ T-LGL leukemias. In the majority of T-LGL leukemia cases, the leukemic LGLs express CD3, CD8 and TCRab.…”