Long-term remission of T-cell large granular lymphocyte leukemia associated with rheumatoid arthritis after rituximab therapy

Cornec, Divi; Devauchelle‐Pensec, Valérie; Jousse‐Joulin, Sandrine; Marhadour, Thierry; Ugo, Valérie; Berthou, Christian; Douet‐Guilbert, Nathalie; Saraux, Alain

doi:10.1182/blood-2013-03-491464

Cited by 31 publications

(28 citation statements)

References 18 publications

(14 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In our opinion, this is not a reasonable option for LGL leukemia. 110,111 Splenectomy. Splenectomy may be considered in patients with symptomatic splenomegaly associated or not with cyopenias.…”

Section: Second-line Therapymentioning

confidence: 99%

LGL leukemia: from pathogenesis to treatment

Lamy

Moignet

Loughran

2017

Blood

244

391

View full text Add to dashboard Cite

Large granular lymphocyte (LGL) leukemia has been recognized by the World Health Organization classifications amongst mature T-cell and natural killer (NK) cell neoplasms. There are 3 categories: chronic T-cell leukemia and NK-cell lymphocytosis, which are similarly indolent diseases characterized by cytopenias and autoimmune conditions as opposed to aggressive NK-cell LGL leukemia. Clonal LGL expansion arise from chronic antigenic stimulation, which promotes dysregulation of apoptosis, mainly due to constitutive activation of survival pathways including Jak/Stat, MapK, phosphatidylinositol 3-kinase–Akt, Ras–Raf-1, MEK1/extracellular signal-regulated kinase, sphingolipid, and nuclear factor-κB. Socs3 downregulation may also contribute to Stat3 activation. Interleukin 15 plays a key role in activation of leukemic LGL. Several somatic mutations including Stat3, Stat5b, and tumor necrosis factor alpha-induced protein 3 have been demonstrated recently in LGL leukemia. Because these mutations are present in less than half of the patients, they cannot completely explain LGL leukemogenesis. A better mechanistic understanding of leukemic LGL survival will allow future consideration of a more targeted therapeutic approach than the current practice of immunosuppressive therapy.

show abstract

Section: Second-line Therapymentioning

confidence: 99%

LGL leukemia: from pathogenesis to treatment

Lamy

Moignet

Loughran

2017

Blood

244

391

View full text Add to dashboard Cite

show abstract

“…57,58 Interestingly, despite the fact that it is a T cell-mediated disease, autoimmune neutropenia may also respond to rituximab. 59 Most patients will also respond to G-CSF, although in the setting of RA, this may cause an acute exacerbation of joint symptoms.…”

Section: Autoimmune Neutropeniamentioning

confidence: 99%

How we evaluate and treat neutropenia in adults

Gibson

Berliner

2014

Blood

101

105

View full text Add to dashboard Cite

Isolated neutropenia is a common clinical problem seen by primary care physicians and hematologists. The evaluation of neutropenia is dictated by the acuity of the clinical presentation and the duration, age, and clinical status of the patient. In this review, we provide a practical approach to the evaluation of the adult patient with neutropenia, with the major focus on the evaluation of neutropenia in the outpatient setting.

show abstract

“…Despite the fact that the majority of reviews about T-cell LGLL have mentioned that cutaneous involvement is rare, there are a few descriptions of different skin presentations, including nodules, ulcers, telangiectasia, and cutaneous thrombotic and necrotizing mycroangiopathy. In 1992, Helm et al described a pyoderma gangrenous-like ulcer, which was a cutaneous manifestation of LGLL [14][15][16][17]. Although we could not ascertain skin infiltration by large granular lymphocytes in our patient, the presentation of ulcers that mimicked pyoderma gangrenous in the histology suggested that this case might have represented a second atypical cutaneous presentation.…”

Section: Discussionmentioning

confidence: 47%

CD20-Positive T-Cell Large Granular Lymphocytic Leukemia: A Case Report and Literature Review

Ferreira¹,

Culler²,

Hencklain³

et al. 2017

J Clin Case Rep

View full text Add to dashboard Cite

T-cell large granular lymphocytic leukemia (T-cell LGLL) is a rare disorder characterized by the monoclonal expansion of CD3-positive cytotoxic T cells. Cell morphology and immunophenotyping are the main tools for diagnosis. Typical phenotypic findings include the expression of markers CD3+, CD5+dim, CD8+, CD16+, CD57+, and T-cell receptor (TCR) αβ (+). However, a few cases may present with the CD3+/CD4+ phenotype or the double expression of CD4 and CD8. Similarly, in 20% of cases, TCRγ/δ is positive. In this study, we aimed to describe a rare, unusual case of T-cell LGLL that exhibited expression of the B-cell antigen, CD20. Additionally, we performed a literature review to compare the clinical characteristics of our patient to those of other patients with CD20-positive T-cell LGLL and to seek new therapeutic possibilities.

show abstract

Long-term remission of T-cell large granular lymphocyte leukemia associated with rheumatoid arthritis after rituximab therapy

Cited by 31 publications

References 18 publications

LGL leukemia: from pathogenesis to treatment

LGL leukemia: from pathogenesis to treatment

How we evaluate and treat neutropenia in adults

CD20-Positive T-Cell Large Granular Lymphocytic Leukemia: A Case Report and Literature Review

Contact Info

Product

Resources

About