Abstract:
Objective To summarize the clinical features, treatment options, and survival prognoses of patients with T-cell large granular lymphocytic leukemia (T-LGLL).
Methods The clinical and laboratory examination data of 21 patients with T-LGLL admitted to Qilu Hospital of Shandong University from February 2009 to December 2019 were retrospectively analyzed, and the clinical characteristics, treatment options, and prognosis of T-LGLL were summarized.
Results The majority of T-LGLL patients were middle-aged and elderly men. The main clinical manifestations included fatigue (61.9%), infection (28.6%), and splenomegaly (61.9%), and 6 cases combined with autoimmune diseases. Routine blood tests of T-LGLL patients usually revealed leukopenia (42.9%) and/or anemia (71.4%). Examination of bone marrow smears showed an increase in the number of large granular lymphocytes, and bone marrow biopsy demonstrated the suppression of granulocyte hyperplasia. The typical T-LGLL immunophenotype was CD3+ CD4- CD8+ CD57+ CD16+, with positivity for T-cell receptor gene rearrangement observed in 88.9% of cases. T-LGLL usually progresses slowly. The total effective rate of immunosuppressive therapy was 60%, with a complete hematological remission rate of 20% and a partial remission rate of 40%.
Conclusions T-LGLL is a disease characterized by cytopenia and a clonal increase in large granular lymphocytes in bone marrow and peripheral blood. It is often complicated by autoimmune diseases. This disease progresses slowly, and the effect of first-line immunosuppressive treatment is acceptable.