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Yang L, Niu H, Zhang T, Cao Q, Liu M, Liu Y, Yan L, Qi W, Wang T, Liu C, Li L, Xing L, Wang H, Shao Z, Fu R. A nomogram model for predicting the efficacy of cyclosporine in patients with pure red cell aplasia. Ann Hematol 2024; 103:1877-1885. [PMID: 38308019 DOI: 10.1007/s00277-024-05636-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 01/19/2024] [Indexed: 02/04/2024]
Abstract
Pure red cell aplasia (PRCA) is a rare bone marrow disorder characterized by a severe reduction or absence of erythroid precursor cells, without affecting granulocytes and megakaryocytes. Immunosuppressive therapies, particularly cyclosporine, have demonstrated efficacy as a primary treatment. This study aims to develop a predictive model for assessing the efficacy of cyclosporine in acquired PRCA (aPRCA). This retrospective study encompasses newly treated aPRCA patients at the General Hospital of Tianjin Medical University. Diagnosis criteria include severe anemia, and absolute reticulocyte count below 10 × 109/L, with normal white blood cell and platelet counts, and a severe reduction in bone marrow erythroblasts. Cyclosporine therapy was administered, with dose adjustments based on blood concentration. Response to cyclosporine was evaluated according to established criteria. Statistical analysis involved logistic multi-factor regression, generating a predictive model. The study included 112 aPRCA patients with a median age of 63.5 years. Patients presented with severe anemia (median Hb, 56 g/L) and reduced reticulocyte levels. Eighty-six patients had no bone marrow nucleated erythroblasts. Primary PRCA accounted for 62 cases (55.4%), and secondary PRCA accounted for 50 cases (44.6%). Univariate analysis revealed that ferritin, platelet to lymphocyte ratio (PLR), and CD4/CD8 ratio influenced treatment response. Multivariate analysis further supported the predictive value of these factors. A prediction model was constructed using ferritin, PLR, and CD4/CD8 ratio, demonstrating high sensitivity and specificity. The ferritin, PLR, and CD4/CD8-based nomogram showed good predictive ability for aPRCA response to cyclosporine. This model has potential clinical value for individualized diagnosis and treatment of aPRCA patients.
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Affiliation(s)
- Liyan Yang
- Department of Hematology, General Hospital, Tianjin Medical University, No. 154 Anshandao Road, Heping District, Tianjin, 300052, China
| | - Haiyue Niu
- Department of Hematology, General Hospital, Tianjin Medical University, No. 154 Anshandao Road, Heping District, Tianjin, 300052, China
| | - Tian Zhang
- Department of Hematology, General Hospital, Tianjin Medical University, No. 154 Anshandao Road, Heping District, Tianjin, 300052, China
| | - Qiuying Cao
- Department of Hematology, General Hospital, Tianjin Medical University, No. 154 Anshandao Road, Heping District, Tianjin, 300052, China
| | - Mengyuan Liu
- Department of Hematology, General Hospital, Tianjin Medical University, No. 154 Anshandao Road, Heping District, Tianjin, 300052, China
| | - Yumei Liu
- Department of Hematology, General Hospital, Tianjin Medical University, No. 154 Anshandao Road, Heping District, Tianjin, 300052, China
| | - Li Yan
- Department of Hematology, General Hospital, Tianjin Medical University, No. 154 Anshandao Road, Heping District, Tianjin, 300052, China
| | - Weiwei Qi
- Department of Hematology, General Hospital, Tianjin Medical University, No. 154 Anshandao Road, Heping District, Tianjin, 300052, China
| | - Ting Wang
- Department of Hematology, General Hospital, Tianjin Medical University, No. 154 Anshandao Road, Heping District, Tianjin, 300052, China
| | - Chunyan Liu
- Department of Hematology, General Hospital, Tianjin Medical University, No. 154 Anshandao Road, Heping District, Tianjin, 300052, China
| | - Lijuan Li
- Department of Hematology, General Hospital, Tianjin Medical University, No. 154 Anshandao Road, Heping District, Tianjin, 300052, China
| | - Limin Xing
- Department of Hematology, General Hospital, Tianjin Medical University, No. 154 Anshandao Road, Heping District, Tianjin, 300052, China
| | - Huaquan Wang
- Department of Hematology, General Hospital, Tianjin Medical University, No. 154 Anshandao Road, Heping District, Tianjin, 300052, China.
| | - Zonghong Shao
- Department of Hematology, General Hospital, Tianjin Medical University, No. 154 Anshandao Road, Heping District, Tianjin, 300052, China.
| | - Rong Fu
- Department of Hematology, General Hospital, Tianjin Medical University, No. 154 Anshandao Road, Heping District, Tianjin, 300052, China.
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Liu H, Guo J, Cao L, Zhu H, Miao Y, Du X, Wu Y, Xu W, Li J, Fan L. A simplified prognostic score for T-cell large granular lymphocyte leukaemia. Ann Med 2023; 55:2258899. [PMID: 37801616 PMCID: PMC10561584 DOI: 10.1080/07853890.2023.2258899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 09/08/2023] [Indexed: 10/08/2023] Open
Abstract
BACKGROUND T-cell large granular lymphocyte leukaemia (T-LGLL) generally has a favourable prognosis, but a small proportion of patients are facing a relatively short survival time. This study aimed to identify clinical factors associated with survival in patients with T-LGLL and develop a predictive model for guiding therapeutic decision-making. MATERIALS AND METHODS We conducted a retrospective study on 120 patients with T-LGLL. Lasso regression was performed for feature selection followed by univariate and multivariate Cox regression analysis. A decision tree algorithm was employed to construct a model for predicting overall survival (OS) in T-LGLL. RESULTS The median age of diagnosis for the entire cohort was 59 years, and 76.7% of patients reported disease-related symptoms. After a median follow-up of 75 months, the median OS was not reached. The 5-year OS rate was 82.2% and the 10-year OS rate was 63.8%. Multivariate analysis revealed that an Eastern Cooperative Oncology Group performance status over two and a platelet count below 100 × 109/L were independently associated with worse OS, leading to the development of a simplified decision tree model. The model's performance was adequate when internally validated. The median OS of the high- and intermediate-risk- risk groups was 43 and 100 months respectively, whereas the median OS of the low-risk group was not reached. Furthermore, we found that immunosuppressive agent-based conventional treatment was unsatisfactory for our high-risk patients. CONCLUSIONS Our model is an easily applicable clinical scoring system for predicting OS in patients with T-LGLL. However, external validation is essential before implementing it widely.
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Affiliation(s)
- Hailing Liu
- Department of Hematology, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing, China
| | - Jingjing Guo
- Department of Geriatric, Nanjing Second Hospital, Nanjing University of Chinese Medicine, Nanjing, China
| | - Lei Cao
- Department of Hematology, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing, China
| | - Huayuan Zhu
- Department of Hematology, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing, China
| | - Yi Miao
- Department of Hematology, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing, China
| | - Xinyi Du
- Department of Hematology, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing, China
| | - Yujie Wu
- Department of Hematology, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing, China
| | - Wei Xu
- Department of Hematology, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing, China
| | - Jianyong Li
- Department of Hematology, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing, China
| | - Lei Fan
- Department of Hematology, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing, China
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Semenzato G, Calabretto G, Barilà G, Gasparini VR, Teramo A, Zambello R. Not all LGL leukemias are created equal. Blood Rev 2023; 60:101058. [PMID: 36870881 DOI: 10.1016/j.blre.2023.101058] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 02/15/2023] [Accepted: 02/17/2023] [Indexed: 02/22/2023]
Abstract
Large Granular Lymphocyte (LGL) Leukemia is a rare, heterogeneous even more that once thought, chronic lymphoproliferative disorder characterized by the clonal expansion of T- or NK-LGLs that requires appropriate immunophenotypic and molecular characterization. As in many other hematological conditions, genomic features are taking research efforts one step further and are also becoming instrumental in refining discrete subsets of LGL disorders. In particular, STAT3 and STAT5B mutations may be harbored in leukemic cells and their presence has been linked to diagnosis of LGL disorders. On clinical grounds, a correlation has been established in CD8+ T-LGLL patients between STAT3 mutations and clinical features, in particular neutropenia that favors the onset of severe infections. Revisiting biological aspects, clinical features as well as current and predictable emerging treatments of these disorders, we will herein discuss why appropriate dissection of different disease variants is needed to better manage patients with LGL disorders.
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Affiliation(s)
- Gianpietro Semenzato
- University of Padova, Department of Medicine, Hematology Unit, Italy; Veneto Institute of Molecular Medicine, Padova, Italy.
| | - Giulia Calabretto
- University of Padova, Department of Medicine, Hematology Unit, Italy; Veneto Institute of Molecular Medicine, Padova, Italy
| | - Gregorio Barilà
- University of Padova, Department of Medicine, Hematology Unit, Italy; Veneto Institute of Molecular Medicine, Padova, Italy
| | - Vanessa Rebecca Gasparini
- University of Padova, Department of Medicine, Hematology Unit, Italy; Veneto Institute of Molecular Medicine, Padova, Italy
| | - Antonella Teramo
- University of Padova, Department of Medicine, Hematology Unit, Italy; Veneto Institute of Molecular Medicine, Padova, Italy.
| | - Renato Zambello
- University of Padova, Department of Medicine, Hematology Unit, Italy; Veneto Institute of Molecular Medicine, Padova, Italy.
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Isolated anemia in patients with large granular lymphocytic leukemia (LGLL). Blood Cancer J 2022; 12:30. [PMID: 35194022 PMCID: PMC8863822 DOI: 10.1038/s41408-022-00632-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Revised: 01/23/2022] [Accepted: 01/28/2022] [Indexed: 11/08/2022] Open
Abstract
Patients with large granular lymphocytic leukemia (LGLL) frequently present with neutropenia. When present, anemia is usually accompanied by neutropenia and/or thrombocytopenia and isolated anemia is uncommon. We evaluated a cohort of 244 LGLL patients spanning 15 years and herein report the clinicopathologic features of 34 (14%) with isolated anemia. The patients with isolated anemia showed a significantly male predominance (p = 0.001), a lower level of hemoglobulin (p < 0.0001) and higher MCV (p = 0.017) and were less likely to have rheumatoid arthritis (p = 0.023) compared to the remaining 210 patients. Of the 34 LGLL patients with isolated anemia, 13 (38%) presented with pure red cell aplasia (PRCA), markedly decreased reticulocyte count and erythroid precursors, and more transfusion-dependence when compared to non-PRCA patients. There was no other significant clinicopathologic difference between PRCA and non-PRCA patients. 32 patients were followed for a median duration of 51 months (6-199). 24 patients were treated (11/11 PRCA and 13/21 non-PRCA patients, p < 0.02). The overall response rate to first-line therapy was 83% [8/11 (72.7%) for PRCA, 12/13 (92.3%) for non-PRCA], including 14 showing complete response and 6 showing partial response with a median response duration of 48 months (12-129). Half of non-PRCA patients who were observed experienced progressive anemia. During follow-up, no patients developed neutropenia; however, 5/27 (18.5%) patients developed thrombocytopenia. No significant difference in overall survival was noted between PRCA and non-PRCA patients. In summary, this study demonstrates the unique features of LGLL with isolated anemia and underscores the importance of recognizing LGLL as a potential cause of isolated anemia, which may benefit from disease-specific treatment. LGLL patients with PRCA were more likely to require treatment but demonstrated similar clinicopathologic features, therapeutic responses, and overall survival compared to isolated anemia without PRCA, suggesting PRCA and non-PRCA of T-LGLL belong to a common disease spectrum.
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Schreiber J, Pichler A, Kornauth C, Kaufmann H, Staber PB, Hopfinger G. T-Cell Large Granular Lymphocyte Leukemia: An Interdisciplinary Issue? Front Oncol 2022; 12:805449. [PMID: 35223485 PMCID: PMC8869758 DOI: 10.3389/fonc.2022.805449] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Accepted: 01/18/2022] [Indexed: 12/18/2022] Open
Affiliation(s)
- Johanna Schreiber
- Department of Internal Medicine III, Division of Hematology and Oncology, Klinik Favoriten, Vienna, Austria
- Department of Medicine I, Division of Hematology, Medical University of Vienna, Vienna, Austria
| | - Alexander Pichler
- Department of Medicine I, Division of Hematology, Medical University of Vienna, Vienna, Austria
| | | | - Hannes Kaufmann
- Department of Internal Medicine III, Division of Hematology and Oncology, Klinik Favoriten, Vienna, Austria
| | - Philipp B. Staber
- Department of Medicine I, Division of Hematology, Medical University of Vienna, Vienna, Austria
| | - Georg Hopfinger
- Department of Internal Medicine III, Division of Hematology and Oncology, Klinik Favoriten, Vienna, Austria
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Xu Q, Yu J, Lin X, Li Y, Zhang K. CB-LPD, MGUS, T-LGLL, and PRCA: A rare case report of 4 concomitant hematological disorders. Medicine (Baltimore) 2021; 100:e27874. [PMID: 34964755 PMCID: PMC8615434 DOI: 10.1097/md.0000000000027874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 11/03/2021] [Indexed: 01/05/2023] Open
Abstract
RATIONALE Monoclonal gammopathy of undetermined significance (MGUS) is a clinically asymptomatic clonal plasma cell or lymphoplasmacytic proliferative disorder. Recently, some case reports have described the association of pure red cell aplasia (PRCA) with MGUS, even with a relatively low monoclonal immunoglobulin burden. T large granular lymphocyte leukemia (T-LGLL) is a chronic lymphoproliferative disorder characterized by clonal expansion of T large granular lymphocytes, which is rare in China. There are some reports about T-LGL leukemia in patients with B-cell lymphoma; however, it is very rare that T-LGLL coexists with MGUS and clonal B-cell lymphoproliferative disorders (CB-LPD). PATIENT CONCERNS A 77-year-old man was hospitalized because of anemia. He was diagnosed with MGUS, CB-LPD, and PRCA. During the development of the disease, a group of abnormal T lymphocytes was detected by flow cytometry of peripheral blood. DIAGNOSIS Combining clinical manifestations with the result of T cell receptor gene rearrangement and immunophenotype, it was consistent with the diagnosis of T large granular lymphocyte leukemia. INTERVENTIONS The patient was treat with bortezomib and dexamethasone regimen, Rituximab and sirolimus. OUTCOMES The patient was transfusion independent after therapies. LESSONS We report a patient with 4 concomitant hematological disorders: T-LGLL, MGUS, CB-LPD, and PRCA, aiming to represent the clinical and flow cytometry characteristics of these concomitant diseases, analyze the mechanism between diseases, and provide a clinical reference.
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Affiliation(s)
- Qinhong Xu
- Department of Hematology, Zhongshan Hospital, Xiamen University, Fujian Medical University Clinic Teaching Hospital, Xiamen, Fujian, China
| | - Jieni Yu
- Department of Hematology, Zhongshan Hospital, Xiamen University, Fujian Medical University Clinic Teaching Hospital, Xiamen, Fujian, China
| | - Xiaoyan Lin
- The Center of Clinical Laboratory, Zhongshan Hospital, Xiamen University, Fujian Medical University Clinic Teaching Hospital, Xiamen, Fujian, China
| | - Youli Li
- Department of Hematology, Zhongshan Hospital, Xiamen University, Fujian Medical University Clinic Teaching Hospital, Xiamen, Fujian, China
| | - Kejie Zhang
- Department of Hematology, Zhongshan Hospital, Xiamen University, Fujian Medical University Clinic Teaching Hospital, Xiamen, Fujian, China
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Xiao PP, Chen XY, Dong ZG, Huang JM, Wang QQ, Chen YQ, Zhang Y. Treatment for CD57-negative γδ T-cell large granular lymphocytic leukemia with pure red cell aplasia: A case report. World J Clin Cases 2021; 9:7818-7824. [PMID: 34621832 PMCID: PMC8462263 DOI: 10.12998/wjcc.v9.i26.7818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 06/28/2021] [Accepted: 07/28/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND T-cell large granular lymphocytic leukemia (T-LGLL) is a rare type of aplastic anemia with diverse clinical manifestations. Concomitant diseases are often present at the first manifestation. We describe the treatment of a patient with CD57-negative γδT-LGLL with pure red cell aplasia (PRCA).
CASE SUMMARY A 34-year-old woman with a 20-year history of anemia visited our hospital owing to severe dizziness and was admitted. Her condition was diagnosed as CD57-negative γδT-LGLL with PRCA through bone marrow cytology, bone marrow pathology, bone marrow flow cytometry, bone marrow multiplex polymerase chain reaction combined with fluorescent fragment analysis, and other tests. Treatment with prednisone, methotrexate, and subcutaneous erythropoietin did not significantly change her hemoglobin level. After treatment with oral cyclophosphamide for 3 mo, her hemoglobin level increased to approximately 100 g/L. After 5 mo of treatment, the patient could perform activities of daily living independently.
CONCLUSION The treatment of CD57-negative γδT-LGLL with PRCA with cyclophosphamide helps to improve prognosis.
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Affiliation(s)
- Ping-Ping Xiao
- Department of Hematology and Rheumatology, The Second Affiliated Hospital of Xiamen Medical College, Xiamen 361021, Fujian Province, China
| | - Xu-Yan Chen
- Department of Hematology and Rheumatology, The Second Affiliated Hospital of Xiamen Medical College, Xiamen 361021, Fujian Province, China
| | - Zhi-Gao Dong
- Department of Hematology and Rheumatology, The Second Affiliated Hospital of Xiamen Medical College, Xiamen 361021, Fujian Province, China
| | - Jin-Mei Huang
- Department of Hematology and Rheumatology, The Second Affiliated Hospital of Xiamen Medical College, Xiamen 361021, Fujian Province, China
| | - Qing-Qing Wang
- Department of Hematology and Rheumatology, The Second Affiliated Hospital of Xiamen Medical College, Xiamen 361021, Fujian Province, China
| | - Yong-Quan Chen
- Department of Hematology and Rheumatology, The Second Affiliated Hospital of Xiamen Medical College, Xiamen 361021, Fujian Province, China
| | - Yi Zhang
- Department of Hematology and Rheumatology, The Second Affiliated Hospital of Xiamen Medical College, Xiamen 361021, Fujian Province, China
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Ruan J, Wang X, Jiang X, Chen M. Acquired pure red cell aplasia and T cell large granular lymphocytic leukaemia in patients with autoimmune polyglandular syndrome type 1. BMC Med Genomics 2021; 14:22. [PMID: 33468135 PMCID: PMC7814426 DOI: 10.1186/s12920-020-00866-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 12/29/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Pure red cell aplasia (PRCA) and large granular lymphocytic leukaemia (LGLL) are very rare complications of autoimmune polyendocrine syndrome type 1 (APS1). Here, we report a case of APS1 with PRCA and LGLL. Previous cases were reviewed, and possible mechanisms are discussed. CASE PRESENTATION A 31-year-old female presented with anaemia and was diagnosed with PRCA in our centre. She also had hypoparathyroidism for 24 years, premature ovarian failure for 10 years, osteoporosis for 5 years, recurrent pneumonia with bronchiectasis for 4 years and chronic diarrhoea for 1 year. Boosted whole-exome analysis showed AIRE heterozygous mutations, confirming the diagnosis as APS1. LGLL was diagnosed during follow-up. The PRCA responded well to glucocorticoid. treatment CONCLUSION: AIRE is causally related to the development of LGLL and consequent PRCA, which may be due to some immunological mechanisms.
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Affiliation(s)
- Jing Ruan
- Hematology Department, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Xuan Wang
- Hematology Department, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Xianyong Jiang
- Hematology Department, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Miao Chen
- Hematology Department, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, 100730, China.
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Cheon H, Dziewulska KH, Moosic KB, Olson KC, Gru AA, Feith DJ, Loughran TP. Advances in the Diagnosis and Treatment of Large Granular Lymphocytic Leukemia. Curr Hematol Malig Rep 2020; 15:103-112. [PMID: 32062772 PMCID: PMC7234906 DOI: 10.1007/s11899-020-00565-6] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
PURPOSE OF REVIEW The past decade in LGL leukemia research has seen increased pairing of clinical data with molecular markers, shedding new insights on LGL leukemia pathogenesis and heterogeneity. This review summarizes the current standard of care of LGL leukemia, updates from clinical trials, and our congruent improved understanding of LGL pathogenesis. RECENT FINDINGS Various clinical reports have identified associations between stem, bone marrow, and solid organ transplants and incidence of LGL leukemia. There is also a potential for underdiagnosis of LGL leukemia within the rheumatoid arthritis patient population, emphasizing our need for continued study. Preliminary results from the BNZ-1 clinical trial, which targets IL-15 along with IL-2 and IL-9 signaling pathways, show some evidence of clinical response. With advances in our understanding of LGL pathogenesis from both the bench and the clinic, exciting avenues for investigations lie ahead for LGL leukemia.
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Affiliation(s)
- HeeJin Cheon
- Department of Medicine, Division of Hematology & Oncology, University of Virginia Cancer Center, PO Box 800334, Charlottesville, VA, 22908-0334, USA
- Department of Biochemistry and Molecular Genetics, Charlottesville, VA, 22908, USA
- Medical Scientist Training Program, Charlottesville, VA, 22908, USA
| | - Karolina H Dziewulska
- Department of Medicine, Division of Hematology & Oncology, University of Virginia Cancer Center, PO Box 800334, Charlottesville, VA, 22908-0334, USA
- Department of Pathology, University of Virginia School of Medicine, Charlottesville, VA, 22908, USA
| | - Katharine B Moosic
- Department of Medicine, Division of Hematology & Oncology, University of Virginia Cancer Center, PO Box 800334, Charlottesville, VA, 22908-0334, USA
- Department of Pathology, University of Virginia School of Medicine, Charlottesville, VA, 22908, USA
| | - Kristine C Olson
- Department of Medicine, Division of Hematology & Oncology, University of Virginia Cancer Center, PO Box 800334, Charlottesville, VA, 22908-0334, USA
| | - Alejandro A Gru
- Department of Pathology, University of Virginia School of Medicine, Charlottesville, VA, 22908, USA
| | - David J Feith
- Department of Medicine, Division of Hematology & Oncology, University of Virginia Cancer Center, PO Box 800334, Charlottesville, VA, 22908-0334, USA
| | - Thomas P Loughran
- Department of Medicine, Division of Hematology & Oncology, University of Virginia Cancer Center, PO Box 800334, Charlottesville, VA, 22908-0334, USA.
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