Response of T‐beta CD8⁺ lymphocytosis‐associated neutropenia to G‐CSF

Abstract

Only limited data are reported on the response to granulocyte-colony stimulating factor (G-CSF) of large granular lymphocytosis-associated neutropenia. We report features of such a case who developed a suppurating leg ulcer following a dog bite. G-CSF was used to increase the neutrophil count, allowing the ulcer to be successfully skin grafted.

Dysfunction of immune system in the development of large granular lymphocyte leukemia

“…Immunosuppressive therapies like the application of low-dose methotrexate (MTX), cyclophosphamide, or cyclosporine slowly and effectively alleviate neutropenia while the effect of using granulocyte-macrophagecolony-stimulating factor (GM-CSF) or granulocyte colony-stimulating factor (G-CSF) alone is usually partial and transient [10,19]. So, the hematopoietic growth factors may be more useful for rapid neutropenia correction in febrile neutropenia patients and conditions in combination with other agents [20][21][22]. Splenectomy was not recommended as a first-line therapy owing to the lack of evidence for the splenic destruction of neutrophils in LGL leukemia and insufficient data on its efficacy in treating the LGL leukemiarelated neutropenia [10,19].…”

T-Cell Large Granular Lymphocyte Leukemia and Related Disorders

“…The most common indication for therapy is recurrent infections secondary to neutropenia. Both G-CSF and GM-CSF improve neutropenia in these patients and are especially beneficial in patients with severe infections [85,86]. Patients with Felty's syndrome may develop autoimmune complications from G-CSF, including vasculitis, arthralgias, and thrombocytopenia, necessitating discontinuation of therapy or lowering of the dose [87].…”