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Cd8 + /vβ5.1 + large granular lymphocyte leukemia associated with autoimmune cytopenias, rheumatoid arthritis and vascular mammary skin lesions: successful response to 2‐deoxycoformycin.
Author(s) -
Granjo E.,
Lima M.,
Correia T.,
Lisboa C.,
Magalhães C.,
Cunha N.,
Teixeira MA.,
Queirós ML.,
Candeias J.,
Matutes E.
Publication year - 2002
Publication title -
hematological oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 44
eISSN - 1099-1069
pISSN - 0278-0232
DOI - 10.1002/hon.695
Subject(s) - medicine , immunology , lymphocytosis , polyarthritis , cd8 , leukemia , t cell receptor , pathology , arthritis , t cell , antigen , immune system
Abstract We report a case of CD8 + /Vβ5.1 + T‐cell large granular lymphocyte leukemia (T‐LGL leukemia) presenting with mild lymphocytosis, severe autoimmune neutropenia, thrombocytopenia, polyarthritis and recurrent infections with a chronic disease course. Immunophenotyping showed an expansion of CD3 + /TCRαβ + /CD8 +bright /CD11c + /CD57 − /CD56 − large granular lymphocytes with expression of the TCR‐Vβ5.1 family. Southern blot analysis revealed a clonal rearrangement of the TCR β‐chain gene. Hematopoietic growth factors, high dose intravenous immunoglobulin and corticosteroids were of limited therapeutic benefit to correct the cytopenias. During the disease course, the patient developed a severe cutaneous leg ulcer and bilateral vascular mammary skin lesions. Treatment with 2‐deoxycoformycin resulted in both clinical and hematological complete responses, including the resolution of vascular skin lesions. Combined immuno‐staining with relevant T‐cell associated and anti‐TCR‐Vβ monoclonal antibodies proved to be a sensitive method to assess the therapeutic effect of 2‐deoxycoformicin and to evaluate the residual disease. Copyright © 2002 John Wiley & Sons, Ltd.