Allergy/Imm Medical News about Leukemia, Rheumatoid arthritis, Neutropenia

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T cell large granular lymphocyte leukemia associated with rheumatoid arthritis and neutropenia
Clinical Immunology, 08/03/09

Shah A et al. – Article presents a case of a patient with rheumatoid arthritis (RA), neutropenia, large granular lymphocytosis, and an expanded clonal population of peripheral blood CD3+CD8+TCRαβ CTLs, consistent with the diagnosis of T cell large granular lymphocyte leukemia (T-LGL). Study concludes that:

T-LGL should be suspected is pts with RA and neutropenia
T-LGLs may have caused neutropenia by suppressing granulopoesis through the secretion of cytokines and chemokines
This patient also had a positive test for serum anti-granulocyte Abs, suggesting that humoral mechanisms may be causing neutropenia
Pt's illness improved dramatically from etanercept therapy, implying that the symptoms were mediated by a proinflammatory mechanism
Therefore, the clinical and biological behavior of T-LGL in this setting resembles that of a chronic inflammatory disease rather than a true malignant process

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