Elliott James, Villiers Elizabeth
Willows Veterinary Centre & Referral Service, Highlands Road, Solihull, B90 4NH, UK.
Dick White Referrals, Station Farm, London Road, Six Mile Bottom, Cambridgeshire, CB8 0UH, UK.
Open Vet J. 2018;8(2):118-124. doi: 10.4314/ovj.v8i2.1. Epub 2018 Apr 1.
In humans, large granular lymphocytic leukaemia (LGLL) is a low-grade, indolent lymphoproliferative disorder of large granular lymphocytes (LGL) associated with autoimmune disorders; including rheumatoid arthritis and single or multiple cytopenias; particularly neutropenia. Therapy largely centres around immunosuppression which aims to resolve the immune-mediated secondary pathology, often without eradicating the neoplastic clone. The most effective agents appear to be cyclophosphamide, cyclosporine and methotrexate. This case report describes the presentation, diagnostics, therapeutic approach and outcome of a 6 year-old Golden Retriever presenting with severe neutropenia. Chlorambucil, prednisolone and cyclosporine failed to improve the neutropenia but subsequent cyclophosphamide resulted in a sustained albeit temporary improvement in neutrophil count and the ability to withdraw prophylactic antibacterials. This case closely mirrors the diagnostics and therapeutic response in human LGLL.
在人类中,大颗粒淋巴细胞白血病(LGLL)是一种与自身免疫性疾病相关的大颗粒淋巴细胞(LGL)的低度、惰性淋巴细胞增殖性疾病,这些自身免疫性疾病包括类风湿性关节炎以及单一或多种血细胞减少症,尤其是中性粒细胞减少症。治疗主要围绕免疫抑制展开,目的是解决免疫介导的继发性病理问题,通常无法根除肿瘤克隆。最有效的药物似乎是环磷酰胺、环孢素和甲氨蝶呤。本病例报告描述了一只6岁金毛寻回犬出现严重中性粒细胞减少症的临床表现、诊断、治疗方法及结果。苯丁酸氮芥、泼尼松龙和环孢素未能改善中性粒细胞减少症,但随后使用环磷酰胺使中性粒细胞计数得到持续改善,尽管是暂时的,并且能够停用预防性抗菌药物。该病例与人类LGLL的诊断和治疗反应极为相似。