Large Granular Lymphocytic Leukemia: A Report of Response to Rituximab
Large granular lymphocytic (LGL) leukemia is a rare form of low grade leukemia characterized by large cytotoxic T cells or natural killer cells on morphological examination. Immunosuppressive therapy is employed as first-line therapy. Treatment options in refractory cases include the anti-CD52 antib...
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| Format: | Article |
| Language: | English |
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Wiley
2017-01-01
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| Series: | Case Reports in Hematology |
| Online Access: | http://dx.doi.org/10.1155/2017/7506542 |
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| _version_ | 1832550020190044160 |
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| author | Uroosa Ibrahim Sara Parylo Shiksha Kedia Shafinaz Hussein Jean Paul Atallah |
| author_facet | Uroosa Ibrahim Sara Parylo Shiksha Kedia Shafinaz Hussein Jean Paul Atallah |
| author_sort | Uroosa Ibrahim |
| collection | DOAJ |
| description | Large granular lymphocytic (LGL) leukemia is a rare form of low grade leukemia characterized by large cytotoxic T cells or natural killer cells on morphological examination. Immunosuppressive therapy is employed as first-line therapy. Treatment options in refractory cases include the anti-CD52 antibody alemtuzumab and purine analogues. We report a rare case that responded to the anti-CD20 monoclonal antibody rituximab. A 77-year-old female presented with complaints of fatigue, fever, and chills of 3 months’ duration. A CBC showed that pancytopenia with an absolute neutrophil count (ANC) was 0. Peripheral blood flow cytometry detected increased number of T cell large granular lymphocytes and T cell receptor rearrangement study detected a clonal T cell population. Bone marrow biopsy showed peripheral T cell lymphoma, most consistent with T-large granulocytic leukemia. The patient was treated with prednisone and oral cyclophosphamide for four months with no response. Thereafter, she received four weekly infusions of rituximab with improvement in her blood counts. A response to rituximab in refractory cases such as ours has been reported and may guide us towards exploring other immune-based therapeutics in this rare disease. |
| format | Article |
| id | doaj-art-998b03df2c7744b9a4ff89c9d8863f9d |
| institution | Kabale University |
| issn | 2090-6560 2090-6579 |
| language | English |
| publishDate | 2017-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Hematology |
| spelling | doaj-art-998b03df2c7744b9a4ff89c9d8863f9d2025-02-03T06:07:58ZengWileyCase Reports in Hematology2090-65602090-65792017-01-01201710.1155/2017/75065427506542Large Granular Lymphocytic Leukemia: A Report of Response to RituximabUroosa Ibrahim0Sara Parylo1Shiksha Kedia2Shafinaz Hussein3Jean Paul Atallah4Department of Hematology/Oncology, Staten Island University Hospital, 475 Seaview Avenue, Staten Island, NY 10305, USADepartment of Medicine, Staten Island University Hospital, 475 Seaview Avenue, Staten Island, NY 10305, USADepartment of Hematology/Oncology, Staten Island University Hospital, 475 Seaview Avenue, Staten Island, NY 10305, USADepartment of Pathology, Staten Island University Hospital, 475 Seaview Avenue, Staten Island, NY 10305, USADepartment of Hematology/Oncology, Staten Island University Hospital, 475 Seaview Avenue, Staten Island, NY 10305, USALarge granular lymphocytic (LGL) leukemia is a rare form of low grade leukemia characterized by large cytotoxic T cells or natural killer cells on morphological examination. Immunosuppressive therapy is employed as first-line therapy. Treatment options in refractory cases include the anti-CD52 antibody alemtuzumab and purine analogues. We report a rare case that responded to the anti-CD20 monoclonal antibody rituximab. A 77-year-old female presented with complaints of fatigue, fever, and chills of 3 months’ duration. A CBC showed that pancytopenia with an absolute neutrophil count (ANC) was 0. Peripheral blood flow cytometry detected increased number of T cell large granular lymphocytes and T cell receptor rearrangement study detected a clonal T cell population. Bone marrow biopsy showed peripheral T cell lymphoma, most consistent with T-large granulocytic leukemia. The patient was treated with prednisone and oral cyclophosphamide for four months with no response. Thereafter, she received four weekly infusions of rituximab with improvement in her blood counts. A response to rituximab in refractory cases such as ours has been reported and may guide us towards exploring other immune-based therapeutics in this rare disease.http://dx.doi.org/10.1155/2017/7506542 |
| spellingShingle | Uroosa Ibrahim Sara Parylo Shiksha Kedia Shafinaz Hussein Jean Paul Atallah Large Granular Lymphocytic Leukemia: A Report of Response to Rituximab Case Reports in Hematology |
| title | Large Granular Lymphocytic Leukemia: A Report of Response to Rituximab |
| title_full | Large Granular Lymphocytic Leukemia: A Report of Response to Rituximab |
| title_fullStr | Large Granular Lymphocytic Leukemia: A Report of Response to Rituximab |
| title_full_unstemmed | Large Granular Lymphocytic Leukemia: A Report of Response to Rituximab |
| title_short | Large Granular Lymphocytic Leukemia: A Report of Response to Rituximab |
| title_sort | large granular lymphocytic leukemia a report of response to rituximab |
| url | http://dx.doi.org/10.1155/2017/7506542 |
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