?? T-cell large granular lymphocyte (LGL) leukemia with spontaneous remission

Publisher Website
Google Scholar
Abstract
T‐cell large granular lymphocyte (LGL) leukemia is a clonal disorder with an indolent clinical course. In July 1995, a 46‐year‐old Japanese man was admitted to our hospital because his anemia had progressed. He had a white blood cell count of 3.9 × 109/L with 75% lymphocytes, which were intermediate to large and had almost round nuclei and azurophilic granules, and anemia with a red blood cell count (RBC) of 2.69 × 1012/L, hemoglobin (Hb) of 9.5 g/dL, and hematocrit (Hct) of 28.3%. Electron microscopic examination showed that most of the lymphocytes had a parallel tubular array and dense core granules in their cytoplasm. Flow cytometry and Southern blotting of the T‐cell antigen receptor (TCR) genes using the peripheral blood species showed monoclonal proliferation of LGLs with a CD3+, TCRγδ+, CD4−, CD8−, CD16+, CD56−, CD57−, HLA‐DR+ phenotype, and a TCR γ gene rearrangement, respectively, suggesting that the patient was diagnosed as having γδ T‐cell LGL leukemia. He had no symptoms, organomegaly, or skin lesions. About 1.5 years after diagnosis, the anemia gradually improved with disappearance and appearance of a rearranged band in the TCR‐γ gene and TCR‐β gene, respectively. About 7 years after diagnosis, the anemia improved completely with a RBC of 5.01 × 1012/L, Hb of 14.8 g/dL, and Hct of 44.3%, and he was in complete remission without TCR‐β and ‐γ gene rearrangements. He had received no therapy. This is the first report of spontaneous remission of γδ T‐cell LGL leukemia. Am. J. Hematol. 75:168–172, 2004.