Clinicopathological features and treatment of aggressive natural killer cell leukemia: case series and literature review

Background. Aggressive natural killer cell leukemia (ANKL) is rare and difficult to diagnose in early stages, with no standard treatment and a poor prognosis. Case presentation. Two adolescents with ANKL presented with hemophagocytic lymphohistiocytosis (HLH), with Case-1 presenting as refractory...

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Main Authors: Yongan Ni, Lei Li, Yuping Wang, Lirong Sun
Format: Article
Language:English
Published: Hacettepe University Institute of Child Health 2024-10-01
Series:The Turkish Journal of Pediatrics
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Online Access:https://turkjpediatr.org/article/view/5072
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author Yongan Ni
Lei Li
Yuping Wang
Lirong Sun
author_facet Yongan Ni
Lei Li
Yuping Wang
Lirong Sun
author_sort Yongan Ni
collection DOAJ
description Background. Aggressive natural killer cell leukemia (ANKL) is rare and difficult to diagnose in early stages, with no standard treatment and a poor prognosis. Case presentation. Two adolescents with ANKL presented with hemophagocytic lymphohistiocytosis (HLH), with Case-1 presenting as refractory HLH and Case-2 with lung involvement. The morphology of bone marrow showed an increase in unidentified cells, which mainly expressed CD56. Cytogenetic analysis showed complex karyotypes. Both patients received intensive combined chemotherapy based on pegaspargase and anthracyclines. Case-1 died of tumor lysis syndrome. Case-2 underwent hematopoietic stem cell transplantation and is currently alive and disease-free. Conclusions. HLH can serve as the initial manifestation of ANKL. Leukemia cells of ANKL have significant variations in the morphology and mainly express CD56. Intensive combination chemotherapy based on pegaspargase and anthracyclines may be considered for ANKL.
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publisher Hacettepe University Institute of Child Health
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spelling doaj-art-e4d3c454b72341d4ba075fe7cc786e7c2025-08-20T02:55:20ZengHacettepe University Institute of Child HealthThe Turkish Journal of Pediatrics0041-43012791-64212024-10-0166410.24953/turkjpediatr.2024.5072Clinicopathological features and treatment of aggressive natural killer cell leukemia: case series and literature reviewYongan Ni0https://orcid.org/0000-0003-0793-7093Lei Li1https://orcid.org/0009-0005-3231-1027Yuping Wang2https://orcid.org/0009-0006-2900-9967Lirong Sun3https://orcid.org/0000-0002-5035-7601Department of Pediatric Hematology and Oncology, the Affiliated Hospital of Qingdao University, Qingdao, Shandong, ChinaDepartment of Respiratory & Cardiovascular Pediatrics, the Affiliated Hospital of Qingdao University, Qingdao, Shandong, ChinaDepartment of Pediatrics, Qingdao Women and Children’s Hospital, Qingdao, Shandong, ChinaDepartment of Pediatric Hematology and Oncology, the Affiliated Hospital of Qingdao University, Qingdao, Shandong, China Background. Aggressive natural killer cell leukemia (ANKL) is rare and difficult to diagnose in early stages, with no standard treatment and a poor prognosis. Case presentation. Two adolescents with ANKL presented with hemophagocytic lymphohistiocytosis (HLH), with Case-1 presenting as refractory HLH and Case-2 with lung involvement. The morphology of bone marrow showed an increase in unidentified cells, which mainly expressed CD56. Cytogenetic analysis showed complex karyotypes. Both patients received intensive combined chemotherapy based on pegaspargase and anthracyclines. Case-1 died of tumor lysis syndrome. Case-2 underwent hematopoietic stem cell transplantation and is currently alive and disease-free. Conclusions. HLH can serve as the initial manifestation of ANKL. Leukemia cells of ANKL have significant variations in the morphology and mainly express CD56. Intensive combination chemotherapy based on pegaspargase and anthracyclines may be considered for ANKL. https://turkjpediatr.org/article/view/5072aggressive NK cell leukemiaasparaginaseanthracyclineshemophagocytic lymphohistiocytosis
spellingShingle Yongan Ni
Lei Li
Yuping Wang
Lirong Sun
Clinicopathological features and treatment of aggressive natural killer cell leukemia: case series and literature review
The Turkish Journal of Pediatrics
aggressive NK cell leukemia
asparaginase
anthracyclines
hemophagocytic lymphohistiocytosis
title Clinicopathological features and treatment of aggressive natural killer cell leukemia: case series and literature review
title_full Clinicopathological features and treatment of aggressive natural killer cell leukemia: case series and literature review
title_fullStr Clinicopathological features and treatment of aggressive natural killer cell leukemia: case series and literature review
title_full_unstemmed Clinicopathological features and treatment of aggressive natural killer cell leukemia: case series and literature review
title_short Clinicopathological features and treatment of aggressive natural killer cell leukemia: case series and literature review
title_sort clinicopathological features and treatment of aggressive natural killer cell leukemia case series and literature review
topic aggressive NK cell leukemia
asparaginase
anthracyclines
hemophagocytic lymphohistiocytosis
url https://turkjpediatr.org/article/view/5072
work_keys_str_mv AT yonganni clinicopathologicalfeaturesandtreatmentofaggressivenaturalkillercellleukemiacaseseriesandliteraturereview
AT leili clinicopathologicalfeaturesandtreatmentofaggressivenaturalkillercellleukemiacaseseriesandliteraturereview
AT yupingwang clinicopathologicalfeaturesandtreatmentofaggressivenaturalkillercellleukemiacaseseriesandliteraturereview
AT lirongsun clinicopathologicalfeaturesandtreatmentofaggressivenaturalkillercellleukemiacaseseriesandliteraturereview