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Gjelberg HK, Helgeland L, Liseth K, Micci F, Sandnes M, Russnes HG, Reikvam H. Long-Smoldering T-prolymphocytic Leukemia: A Case Report and a Review of the Literature. Curr Oncol 2023; 30:10007-10018. [PMID: 37999147 PMCID: PMC10669936 DOI: 10.3390/curroncol30110727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 11/10/2023] [Accepted: 11/14/2023] [Indexed: 11/25/2023] Open
Abstract
T-prolymphocytic leukemia (T-PLL) is a rare malignancy of mature T-cells with distinct clinical, cytomorphological, and molecular genetic features. The disease typically presents at an advanced stage, with marked leukocytosis, B symptoms, hepatosplenomegaly, and bone marrow failure. It usually follows an aggressive course from presentation, and the prognosis is often considered dismal; the median overall survival is less than one year with conventional chemotherapy. This case report describes a patient with T-PLL who, after an unusually protracted inactive phase, ultimately progressed to a highly invasive, organ-involving disease. After initial treatments failed, a novel treatment approach resulted in a significant response.
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Affiliation(s)
- Hilde K. Gjelberg
- Department of Pathology, Haukeland University Hospital, N-5021 Bergen, Norway; (H.K.G.); (L.H.)
| | - Lars Helgeland
- Department of Pathology, Haukeland University Hospital, N-5021 Bergen, Norway; (H.K.G.); (L.H.)
- Department of Clinical Science, University of Bergen, N-5021 Bergen, Norway
| | - Knut Liseth
- Department of Immunology and Transfusion Medicine, Haukeland University Hospital, N-5021 Bergen, Norway;
| | - Francesca Micci
- Section for Cancer Cytogenetics, Institute of Cancer Genetics and Informatics, Oslo University Hospital, N-0424 Oslo, Norway;
| | - Miriam Sandnes
- Department of Medicine, Haukeland University Hospital, N-5021 Bergen, Norway;
| | - Hege G. Russnes
- Department of Pathology, Oslo University Hospital, N-0424 Oslo, Norway;
- Department of Cancer Genetics, Institute for Cancer Research, Oslo University Hospital, N-0424 Oslo, Norway
- Institute for Clinical Medicine, Faculty of Medicine, University of Oslo, N-0424 Oslo, Norway
| | - Håkon Reikvam
- Department of Medicine, Haukeland University Hospital, N-5021 Bergen, Norway;
- Department of Medical Science, University of Bergen, N-5021 Bergen, Norway
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Yahya HA, Khan N, Barta S, Nejati R. A Rare Association: Autoimmune Hemolytic Anemia With Indolent T-Cell Prolymphocytic Leukemia. Cureus 2020; 12:e7994. [PMID: 32523849 PMCID: PMC7274264 DOI: 10.7759/cureus.7994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
The association of warm autoimmune hemolytic anemia (wAIHA) with various lymphoproliferative disorders is well reported in the literature. But the association of wAIHA with T-cell prolymphocytic leukemia (T-PLL), a very rare lymphoproliferative disorder, has never been reported. A 71-year-old man was in his usual state of health until three years ago when he developed intermittent bouts of worsening anemia associated with mild peripheral blood lymphocytosis. He was diagnosed with wAIHA and steroid therapy was initiated, resulting in an improvement in the hemoglobin level of the patient. His lymphocyte count remained persistently elevated but he did not develop any malignancy-related signs or symptoms. A diagnosis of ‘indolent’ T-cell prolymphocytic leukemia (small cell variant) was made by combining distinctive clinical, morphologic, immunophenotypic, and cytogenetic analysis. His wAIHA went into complete remission and steroid therapy was successfully tapered off. He has not required any treatment for his T-PLL during the last two years' follow-up.
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Affiliation(s)
- Hafiz A Yahya
- Pathology, Fox Chase Cancer Center, Philadelphia, USA
| | - Nadia Khan
- Hematology/Oncology, Fox Chase Cancer Center, Temple University Health System, Philadelphia, USA
| | - Stefan Barta
- Hematology/Oncology, Abramson Cancer Center, University of Pennsylvania, Philadelphia, USA
| | - Reza Nejati
- Pathology/Hematopathology, Fox Chase Cancer Center, Philadelphia, USA
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