Rosamilio R, Giudice V, Ferrara I, Annunziata S, Pezzullo L, Villani G, Baldi C, Guariglia R, Rocco M, Selleri C
Department of Medicine and Surgery, University of Salerno, Baronissi, Italy.
Transl Med UniSa. 2016 Nov 1;15:80-83. eCollection 2016 Nov.
T-large granular lymphocyte leukemia (T-LGLL) is a chronic clonal proliferation of effector memory cytotoxic CD3CD57CD56 T cells and the current guidelines suggest immunosuppressive therapy as first-line therapy, but the treatment of refractory/relapsed patients is still challenging due to the lack of prospective studies. We describe a series of two refractory/relapsed T-LGLL patients successfully treated with bendamustine, a chemotherapeutic agent largely used for B-cell neoplasms, but poorly investigated for the treatment of T-cell diseases. Complete remission (CR) was achieved in 3 and 6 months, respectively, and maintained for at least 20 months. One patient relapsed after a 20-month CR, but she was responsive to bendamustine therapy again, obtaining a further prolonged CR. Bendamustine as single agent or in combination could be a feasible therapeutic option in refractory/relapsed T-LGLL, especially for elderly patients because of its safety profile.
T 大颗粒淋巴细胞白血病（T-LGLL）是效应记忆细胞毒性 CD3CD57CD56 T 细胞的慢性克隆性增殖，目前的指南建议将免疫抑制治疗作为一线治疗，但由于缺乏前瞻性研究，难治性/复发性患者的治疗仍然具有挑战性。我们描述了一系列两例难治性/复发性 T-LGLL 患者，他们成功接受了苯达莫司汀治疗，苯达莫司汀是一种主要用于 B 细胞肿瘤的化疗药物，但对其治疗 T 细胞疾病的研究较少。分别在 3 个月和 6 个月时实现了完全缓解（CR），并维持了至少 20 个月。一名患者在 20 个月的 CR 后复发，但她对苯达莫司汀治疗再次有反应，获得了进一步延长的 CR。苯达莫司汀单药或联合用药可能是难治性/复发性 T-LGLL 的一种可行治疗选择，特别是对于老年患者，因其安全性。
