Kuroda Hiroyuki, Sakurai Tamaki, Yamada Michiko, Abe Tomoyuki, Fujii Shigeyuki, Maeda Masahiro, Kohda Kyuhei, Hirayama Yasuo, Jyomen Wataru, Uemura Naoki, Ono Michihiro, Fujimi Yuko, Iyama Satoshi, Sato Tsutomu, Kato Junji
Department of Gastroenterology and Hematology/Clinical Oncology, Internal Medicine, Steel Memorial Muroran Hospital, Japan.
Gan To Kagaku Ryoho. 2011 Oct;38(10):1727-32.
There have been only three reports in the literature of T-cell large granular lymphocyte (T-LGL) leukemia occurring after autologous peripheral stem cell transplantation (APBSCT). We describe 3 patients in whom a transient monoclonal T-LGL developed after APBSCT for malignant lymphoma. Case 1: A 58-year-old man with peripheral T-cell lymphoma in second complete remission (CR) who underwent APBSCT. Case 2: A 51-year-old man with follicular lymphoma in second CR who underwent APBSCT. Case 3: A 65-year-old man with diffuse large B-cell lymphoma in second CR who underwent tandem APBSCT. One month after transplant, fever followed by the proliferation of CD8+/CD57+ T-LGL in peripheral blood occurred in all three cases. Because clonal rearrangements of the T-cell receptor were detected in peripheral blood samples, T-LGL leukemia was diagnosed. The first patient had episodes of Epstein-Barr virus viremia. The other patients suffered from cytomegalovirus colitis after APBSCT. These data show that T-LGL leukemia can occur after viral infection followed by APBSCT.
文献中仅有3例关于自体外周血干细胞移植(APBSCT)后发生T细胞大颗粒淋巴细胞(T-LGL)白血病的报道。我们描述了3例在接受APBSCT治疗恶性淋巴瘤后出现短暂性单克隆T-LGL的患者。病例1:一名58岁男性,外周T细胞淋巴瘤处于第二次完全缓解(CR)期,接受了APBSCT。病例2:一名51岁男性,滤泡性淋巴瘤处于第二次CR期,接受了APBSCT。病例3:一名65岁男性,弥漫性大B细胞淋巴瘤处于第二次CR期,接受了串联APBSCT。移植后1个月,所有3例患者均出现发热,随后外周血中CD8+/CD57+ T-LGL增殖。由于在外周血样本中检测到T细胞受体的克隆重排,故诊断为T-LGL白血病。首例患者发生了爱泼斯坦-巴尔病毒血症。其他患者在APBSCT后患有巨细胞病毒结肠炎。这些数据表明,病毒感染后再进行APBSCT可能会发生T-LGL白血病。