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Fang H, Wang SA, Beird HC, Tang Z, You MJ, Li S, Xu J, Hu S, Yin CC, El Hussein S, Lin P, Jelloul FZ, Vega F, Medeiros LJ, Wang W. Morphology, immunophenotype, and suggested diagnostic criteria of TCL1 family-negative T-prolymphocytic leukemia. Am J Clin Pathol 2024:aqae075. [PMID: 38946194 DOI: 10.1093/ajcp/aqae075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Accepted: 05/26/2024] [Indexed: 07/02/2024] Open
Abstract
OBJECTIVES We sought to investigate the morphologic and immunophenotypic characteristics of TCL1 family-negative T-cell prolymphocytic leukemia (T-PLL). METHODS Twenty cases of TCL1 family-negative T-PLL were studied. RESULTS The doubling time of leukemic cells ranged from less than 2 days to more than 5 years, with a median of 5.5 months. Leukemic cells were small to medium-sized, with round to irregular nuclei, variably condensed chromatin, and small amounts of agranular cytoplasm. A visible nucleolus was identified in 11 (55%) cases. Cytoplasmic blebs/protrusions were identified in all cases, but their occurrence was highly variable from case to case. Bone marrow biopsy showed an interstitial pattern in 90% of cases and a diffuse pattern in the remaining 10% of cases. Flow cytometric immunophenotypic analysis showed that the leukemic cells in all cases were CD4 positive; 3 (15%) also showed concurrent CD8 expression. All cases were positive for CD2 and CD5. Surface CD3 and CD7 were positive in 19 of 20 (95%) cases, and all CD3-positive cases expressed the T-cell receptor αβ. Compared with prototypic T-PLL cases, these 2 groups shared many immunophenotypic findings, except CD8 and CD26, both of which were more commonly expressed in prototypic T-PLL cases. CONCLUSIONS TCL1 family-negative T-PLL cases have morphologic and immunophenotypic features that are similar to prototypic T-PLL. They are characterized by neoplastic proliferation of small to medium-sized mature T cells with CD4-positive T-cell receptor αβ phenotype. Tumor cells frequently maintain pan-T antigen expression. Recognizing these morphologic and immunophenotypic features will aid in accurately diagnosing this rare subset of T-PLL.
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Affiliation(s)
- Hong Fang
- Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, US
| | - Sa A Wang
- Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, US
| | - Hannah C Beird
- Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, US
| | - Zhenya Tang
- Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, US
| | - M James You
- Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, US
| | - Shaoying Li
- Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, US
| | - Jie Xu
- Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, US
| | - Shimin Hu
- Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, US
| | - C Cameron Yin
- Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, US
| | - Siba El Hussein
- Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, US
| | - Pei Lin
- Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, US
| | - Fatima Zahra Jelloul
- Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, US
| | - Francisco Vega
- Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, US
| | - L Jeffrey Medeiros
- Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, US
| | - Wei Wang
- Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, US
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2
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Fang H, Beird HC, Wang SA, Ibrahim AF, Tang Z, Tang G, You MJ, Hu S, Xu J, Li S, Yin CC, El Hussein S, Le N, Futreal PA, Bueso-Ramos C, Thakral B, Kadia TM, Thornton R, Little L, Gumbs C, Song X, Medeiros LJ, Wang W. T-prolymphocytic leukemia: TCL1 or MTCP1 rearrangement is not mandatory to establish diagnosis. Leukemia 2023; 37:1919-1921. [PMID: 37443196 DOI: 10.1038/s41375-023-01956-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 06/01/2023] [Accepted: 06/26/2023] [Indexed: 07/15/2023]
Affiliation(s)
- Hong Fang
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Hannah C Beird
- Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Sa A Wang
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Andrew F Ibrahim
- Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
- Texas Tech University Health Sciences Center School of Medicine, Lubbock, TX, USA
| | - Zhenya Tang
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Guilin Tang
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - M James You
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Shimin Hu
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jie Xu
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Shaoying Li
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - C Cameron Yin
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Siba El Hussein
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Nhi Le
- Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - P Andrew Futreal
- Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Carlos Bueso-Ramos
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Beenu Thakral
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Tapan M Kadia
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Rebecca Thornton
- Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Latasha Little
- Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Curtis Gumbs
- Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Xingzhi Song
- Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - L Jeffrey Medeiros
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Wei Wang
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
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Edmonds N, Guerra R, Noland MMB, Schenck O, Krasner B, Gru AA. An unusual case of T-cell prolymphocytic leukemia mimicking a cutaneous vasculitis. J Cutan Pathol 2021; 48:1311-1316. [PMID: 34089197 DOI: 10.1111/cup.14079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 05/29/2021] [Accepted: 06/01/2021] [Indexed: 11/30/2022]
Abstract
T-cell prolymphocytic leukemia (T-PLL) is an aggressive post-thymic T-cell malignancy, which accounts for 2% of mature lymphocytic leukemias in adults. Though typically presenting with a brief history of B symptoms, hepatosplenomegaly, and marked lymphocytosis, erythematous or nodular skin rashes involving the trunk or limbs may be seen in 25% to 30% of patients, as well as a purpuric rash in a periorbital distribution. Cutaneous involvement typically presents in the context of patients with an established history of T-PLL, but it can less frequently present as an initial symptom heralding the diagnosis. An unusual case of T-PLL is described, presenting initially as palmoplantar ulcerated nodules with an initial biopsy suggestive of perniosis, followed by rapid progression of dark violaceous and bright red papules throughout the body after initiation of Obinutuzumab. The diagnosis of T-PLL was subsequently fully supported by the clinical, laboratory, cytologic, and immunophenotypic findings. This case highlights the importance of a multidisciplinary team approach to address such rare and atypical presentations.
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Affiliation(s)
- Nicole Edmonds
- Department of Dermatology, University of Virginia, Charlottesville, Virginia, USA
| | - Ricardo Guerra
- Department of Dermatology, University of Virginia, Charlottesville, Virginia, USA
| | - Mary-Margaret B Noland
- Department of Pathology and Dermatology, University of Virginia, Charlottesville, Virginia, USA
| | - Olivia Schenck
- Department of Dermatology, University of Virginia, Charlottesville, Virginia, USA
| | - Brett Krasner
- Department of Dermatology, Family Albemarle Dermatology, Charlottesville, Virginia, USA
| | - Alejandro A Gru
- Department of Pathology and Dermatology, University of Virginia, Charlottesville, Virginia, USA
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4
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Wang HY, Murray SS, Bejar R. Indolent T-cell prolymphocytic leukemia with no expression of surface T-cell receptors or surface CD3. Int J Lab Hematol 2021; 43:O224-O226. [PMID: 33855780 DOI: 10.1111/ijlh.13529] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 02/16/2021] [Accepted: 03/03/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Huan-You Wang
- Division of Laboratory and Genomic Medicine, Department of Pathology, University of California San Diego Health System, La Jolla, CA, USA
| | - Sarah S Murray
- Division of Laboratory and Genomic Medicine, Department of Pathology, University of California San Diego Health System, La Jolla, CA, USA
| | - Rafael Bejar
- Division of Hematology and Oncology, Department of Medicine, University of California San Diego Health System, La Jolla, CA, USA
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Nozaki K, Yokota T, Itotagawa E, Tsutsumi K, Kusakabe S, Morikawa Y, Fujita J, Fukushima K, Maeda T, Shibayama H, Hosen N, Kumanogo A, Kanakura Y. Whole-exome sequencing identified mutational profile of a case with T-cell chronic lymphocytic leukemia. Clin Case Rep 2020; 8:2251-2254. [PMID: 33235770 PMCID: PMC7669389 DOI: 10.1002/ccr3.3149] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 05/26/2020] [Accepted: 06/12/2020] [Indexed: 11/11/2022] Open
Abstract
We believe that our report and further case reports on T-cell chronic lymphocytic leukemia with genetic profile will contribute to the molecular classification of this rare but distinct disease.
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Affiliation(s)
- Kenji Nozaki
- Department of Hematology and OncologyOsaka University Graduate School of MedicineSuitaJapan
| | - Takafumi Yokota
- Department of Hematology and OncologyOsaka University Graduate School of MedicineSuitaJapan
| | - Eri Itotagawa
- Department of Respiratory Medicine and Clinical ImmunologyGraduate School of MedicineOsaka UniversitySuitaJapan
| | - Kazuhito Tsutsumi
- Department of Hematology and OncologyOsaka University Graduate School of MedicineSuitaJapan
| | - Shinsuke Kusakabe
- Department of Hematology and OncologyOsaka University Graduate School of MedicineSuitaJapan
| | - Yoichiro Morikawa
- Department of Hematology and OncologyOsaka University Graduate School of MedicineSuitaJapan
| | - Jiro Fujita
- Department of Hematology and OncologyOsaka University Graduate School of MedicineSuitaJapan
| | - Kentaro Fukushima
- Department of Hematology and OncologyOsaka University Graduate School of MedicineSuitaJapan
| | - Tetsuo Maeda
- Department of Hematology and OncologyOsaka University Graduate School of MedicineSuitaJapan
| | - Hirohiko Shibayama
- Department of Hematology and OncologyOsaka University Graduate School of MedicineSuitaJapan
| | - Naoki Hosen
- Department of Hematology and OncologyOsaka University Graduate School of MedicineSuitaJapan
| | - Atsushi Kumanogo
- Department of Respiratory Medicine and Clinical ImmunologyGraduate School of MedicineOsaka UniversitySuitaJapan
| | - Yuzuru Kanakura
- Department of Hematology and OncologyOsaka University Graduate School of MedicineSuitaJapan
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Abstract
PURPOSE OF REVIEW We aimed to produce a comprehensive update on clinical and biological data regarding two rare lymphoid neoplasms, B and T prolymphocytic leukemias, and assess therapeutic management in the light of new molecular insights and the advent of targeted therapies. RECENT FINDINGS B cell prolymphocytic leukemia (B-PLL) diagnosis remains challenging in the absence of clear immunophenotypic or cytogenetic signature and overlap with mantle cell lymphoma. New molecular defects have been identified in T cell prolymphocytic leukemia (T-PLL), especially in the JAK STAT pathway. Like in chronic lymphocytic leukemia (CLL), B-PLL treatment depends on the presence of TP53 dysfunction. In T-PLL, alemtuzumab still remains the standard of care. Allogeneic transplantation is the only curable option. Thanks to reduced intensity conditioning regimens, it has become accessible to a larger number of patients. PLL prognosis remains poor with conventional therapies. However, great advances in the understanding of both T- and B-PLL pathogenesis lead to promising new therapeutic agents.
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7
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Sun Y, Tang G, Hu Z, Thakral B, Miranda RN, Medeiros LJ, Wang SA. Comparison of karyotyping, TCL1 fluorescence in situ hybridisation and TCL1 immunohistochemistry in T cell prolymphocytic leukaemia. J Clin Pathol 2017; 71:309-315. [DOI: 10.1136/jclinpath-2017-204616] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Revised: 07/12/2017] [Accepted: 07/19/2017] [Indexed: 11/04/2022]
Abstract
AimsT cell prolymphocytic leukaemia (T-PLL) is defined as an aggressive T cell leukaemia composed of small to medium-sized lymphocytes with a mature T cell immunophenotype. Most of these cases are known to be associated with inv(14q11q32)/t(14;14)(q11;q32) or rarely t(X;14)(q28;q11). However, T-PLL can show variations in clinical presentation, morphology or immunophenotype that can make a diagnosis of T-PLL challenging. We aim to explore the value of ancillary testing in the diagnosis of T-PLL.MethodsWith this large cohort of 69 patients with T-PLL, we compared the diagnostic utility of conventional cytogenetics, TCL1 rearrangement by fluorescence in situ hybridisation (FISH) and TCL1 expression by immunohistochemistry (IHC).ResultsConventional karyotyping was performed in all 69 patients and was abnormal in 44 (65%), showing 14q32 abnormalities in 31 (43%) and t(X;14) (MTCP) in 2 (3%). TCL1 rearrangement was assessed by FISH in 26 cases and was positive in 23 (85%). All cases with 14q32 abnormalities shown by karyotype were positive for TCL1 rearrangement by FISH, whereas 12/15 (80%) cases without 14q32 abnormalities were also positive. TCL1 overexpression by IHC was detected in 51/64 (81%), including 40/42 (95%) cases with TCL1/14q32 rearrangement, and 3 cases without, showing a concordance of 89%. TCL1 IHC was negative in both cases with t(X;14)(q28;q11).ConclusionsOur study shows that TCL1 by IHC is a convenient test, positive in >80% T-PLL. Conventional cytogenetics is insensitive in the detection of 14q32/TCL1 rearrangements but provides more complete information of the chromosomal landscape of T-PLL. FISH for TCL1 rearrangement is very valuable in diagnostic challenging cases.
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8
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Hu Z, Medeiros LJ, Fang L, Sun Y, Tang Z, Tang G, Sun T, Quesada AE, Hu S, Wang SA, Pei L, Lu X. Prognostic significance of cytogenetic abnormalities in T-cell prolymphocytic leukemia. Am J Hematol 2017; 92:441-447. [PMID: 28194886 DOI: 10.1002/ajh.24679] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Revised: 01/30/2017] [Accepted: 02/08/2017] [Indexed: 01/04/2023]
Abstract
T-cell prolymphocytic leukemia (T-PLL) is an aggressive mature T-cell neoplasm. The most common cytogenetic abnormality associated with T-PLL is inv(14)(q11.2q32) involving TCL1, but other abnormalities also have been reported. In this study, we correlated cytogenetic abnormalities with clinical outcome in 97 T-PLL patients, including 66 men and 31 women with a median age of 63 years (range, 34-81). Twenty-seven patients had a normal karyotype (NK), one had two chromosomal aberrations, and 69 had a complex karyotype (CK). Patients with a CK had poorer overall survival (OS) than patients with a NK (P = .0016). In the CK group, the most common aberrations involved 14q (n = 45) and 8q (n = 38). Additional deletions of chromosomes 17p, 11q, 6q, 12p, 13q were observed frequently. No individual cytogenetic abnormality impacted OS. Patients with ≥5 aberrations had an OS of 11 months versus 22 months in patients with <5 aberrations (P = 0.0132). Fluorescence in situ hybridization for TCL1 successfully performed in 27 cases showed rearrangement in 8/10 (80%) NK versus 16/17 (94%) CK cases. OS of patients with TCL1 rearrangement and/or 14q aberrations was not significantly different from patients without TCL1 rearrangement and 14q aberrations (P = .3467). Patients with refractory disease showed worse OS in both the NK and CK groups (P = .0014 and P < .0001, respectively), compared with patients who achieved remission but then relapsed. Stem cell transplantation did not appear to improve OS regardless of karyotype complexity. In conclusion, patients with T-PLL often have a CK which is a poor prognostic factor, particularly in patients with ≥5 cytogenetic aberrations.
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Affiliation(s)
- Zhihong Hu
- Department of HematopathologyThe University of Texas MD Anderson Cancer CenterHouston Texas USA
| | - L. Jeffrey Medeiros
- Department of HematopathologyThe University of Texas MD Anderson Cancer CenterHouston Texas USA
| | - Lianghua Fang
- Department of HematopathologyThe University of Texas MD Anderson Cancer CenterHouston Texas USA
- Department of OncologyJiangsu Province Hospital of Traditional Chinese MedicineNanjing Jiangsu China
| | - Yi Sun
- Department of HematopathologyThe University of Texas MD Anderson Cancer CenterHouston Texas USA
| | - Zhenya Tang
- Department of HematopathologyThe University of Texas MD Anderson Cancer CenterHouston Texas USA
| | - Guilin Tang
- Department of HematopathologyThe University of Texas MD Anderson Cancer CenterHouston Texas USA
| | - Tsieh Sun
- Department of HematopathologyThe University of Texas MD Anderson Cancer CenterHouston Texas USA
| | - Andres E. Quesada
- Department of HematopathologyThe University of Texas MD Anderson Cancer CenterHouston Texas USA
| | - Shimin Hu
- Department of HematopathologyThe University of Texas MD Anderson Cancer CenterHouston Texas USA
| | - Sa A. Wang
- Department of HematopathologyThe University of Texas MD Anderson Cancer CenterHouston Texas USA
| | - Lin Pei
- Department of HematopathologyThe University of Texas MD Anderson Cancer CenterHouston Texas USA
| | - Xinyan Lu
- Department of HematopathologyThe University of Texas MD Anderson Cancer CenterHouston Texas USA
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9
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Kawamoto K, Miyoshi H, Yanagida E, Yoshida N, Kiyasu J, Kozai Y, Morikita T, Kato T, Suzushima H, Tamura S, Muta T, Kato K, Eto T, Seki R, Nagafuji K, Sone H, Takizawa J, Seto M, Ohshima K. Comparison of clinicopathological characteristics between T-cell prolymphocytic leukemia and peripheral T-cell lymphoma, not otherwise specified. Eur J Haematol 2017; 98:459-466. [DOI: 10.1111/ejh.12856] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/22/2017] [Indexed: 12/25/2022]
Affiliation(s)
- Keisuke Kawamoto
- Department of Pathology; School of Medicine; Kurume University; Kurume Japan
- Department of Hematology, Endocrinology, and Metabolism; Faculty of Medicine; Niigata University; Niigata Japan
| | - Hiroaki Miyoshi
- Department of Pathology; School of Medicine; Kurume University; Kurume Japan
| | - Eriko Yanagida
- Department of Pathology; School of Medicine; Kurume University; Kurume Japan
| | - Noriaki Yoshida
- Department of Pathology; School of Medicine; Kurume University; Kurume Japan
| | | | - Yasuji Kozai
- Department of Hematology; Tokyo Metropolitan Tama Medical Center; Fuchu Japan
| | - Tatsuma Morikita
- Division of Medical Oncology; Saiseikai Kumamoto Hospital; Kumamoto Japan
| | - Takeharu Kato
- Department of Hematology; Sasebo City General Hospital; Sasebo Japan
| | - Hitoshi Suzushima
- Department of Hematology; Kumamoto Shinto General Hospital; Kumamoto Japan
| | - Shinobu Tamura
- Department of Hematology and Oncology; Wakayama Medical University; Wakayama Japan
| | - Tsuyoshi Muta
- Department of Hematology; Japan Community Health Care Organization Kyushu Hospital; Kitakyushu Japan
| | - Koji Kato
- Department of Medicine and Biosystemic Science; Kyushu University Graduate School of Medical Sciences; Fukuoka Japan
| | - Tetsuya Eto
- Department of Hematology; Hamanomachi Hospital; Fukuoka Japan
| | - Ritsuko Seki
- Department of Hematology and Oncology; School of Medicine; Kurume University; Kurume Japan
| | - Koji Nagafuji
- Department of Hematology and Oncology; School of Medicine; Kurume University; Kurume Japan
| | - Hirohito Sone
- Department of Hematology, Endocrinology, and Metabolism; Faculty of Medicine; Niigata University; Niigata Japan
| | - Jun Takizawa
- Department of Hematology, Endocrinology, and Metabolism; Faculty of Medicine; Niigata University; Niigata Japan
| | - Masao Seto
- Department of Pathology; School of Medicine; Kurume University; Kurume Japan
| | - Koichi Ohshima
- Department of Pathology; School of Medicine; Kurume University; Kurume Japan
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10
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Matutes E, Polliack A. T-cell prolymphocytic leukemia: survival improves with alemtuzemab, but stem cell transplant eligibility 'counts' even more. Leuk Lymphoma 2015; 57:746-7. [PMID: 26293613 DOI: 10.3109/10428194.2015.1081195] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Estella Matutes
- a Haematopathology Unit , Hospital Clinic of Barcelona , Spain and
| | - Aaron Polliack
- b Department of Hematology , Hadassah University Hospital and Hebrew University Medical School , Jerusalem , Israel
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