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犬T细胞白血病(大颗粒淋巴细胞变异型)的回顾性研究:与疑似免疫介导性血细胞减少相关且无外周淋巴细胞增多症

Retrospective Study of T Cell Leukaemia (Large Granular Lymphocyte Variant) in Dogs Associated with Suspected Immune-Mediated Cytopaenia(s) in the Absence of Peripheral Lymphocytosis.

作者信息

Capasso Angelo, Villers Elizabeth, Elliott James, Ilchyshyn Nic, Hopkins Ian, Sanchez Ferran Valls, Verganti Sara

机构信息

Department of Oncology, Dick White Referrals, Station Farm, London Road, Six Mile Bottom CB8 0UH, UK.

Department of Pathology, Dick White Referrals, Station Farm, London Road, Six Mile Bottom CB8 0UH, UK.

出版信息

Animals (Basel). 2023 Jan 20;13(3):357. doi: 10.3390/ani13030357.

Abstract

Canine chronic large granular lymphocyte (LGL) leukaemia is commonly characterised by moderate to marked lymphocytosis but not neutropaenia. In humans, LGL leukaemia is often associated with autoimmune disorders, including immune-mediated cytopaenias (mainly neutropaenia). This presentation is rare in dogs. The aim of this retrospective study was to describe the clinical characteristics, treatments, and outcomes of dogs with chronic LGL leukaemia with suspected immune-mediated cytopaenia. Six dogs with a median age of 4.5 years (range 2-8 years) were included in the study. The most common presenting signs were pyrexia and lethargy. All dogs had severe neutropaenia (median neutrophil count 0.07 × 10/L), three had thrombocytopaenia (median platelet count 66 × 10/L), and one had anaemia (HCT 0.32 L/L). In all dogs, bone marrow cytology revealed infiltration of granular T lymphocytes; PARR analysis confirmed clonality in four, and bone marrow flow cytometry identified CD3+ CD8+ neoplastic cells in two cases. All patients received systemic chemotherapy, and the cytopaenias resolved after 1-19 weeks. Two dogs were euthanised 133 and 322 days after diagnosis, two were lost to follow-up after 224 and 357 days, and two were alive at 546 and 721 days. A subset of LGL leukaemia in dogs is associated with immune-mediated cytopaenia and has a unique clinical presentation.

摘要

犬慢性大颗粒淋巴细胞(LGL)白血病通常表现为中度至显著的淋巴细胞增多,但无中性粒细胞减少。在人类中,LGL白血病常与自身免疫性疾病相关,包括免疫介导的血细胞减少症(主要是中性粒细胞减少症)。这种表现在犬中很少见。这项回顾性研究的目的是描述疑似免疫介导的血细胞减少症的慢性LGL白血病犬的临床特征、治疗方法和预后。该研究纳入了6只中位年龄为4.5岁(范围2 - 8岁)的犬。最常见的临床表现为发热和嗜睡。所有犬均有严重的中性粒细胞减少(中位中性粒细胞计数0.07×10⁹/L),3只有血小板减少(中位血小板计数66×10⁹/L),1只有贫血(血细胞比容0.32 L/L)。所有犬的骨髓细胞学检查均显示颗粒T淋巴细胞浸润;PARR分析在4只犬中证实了克隆性,骨髓流式细胞术在2例中鉴定出CD3⁺CD8⁺肿瘤细胞。所有患者均接受了全身化疗,血细胞减少症在1 - 19周后得到缓解。2只犬在诊断后133天和322天实施安乐死,2只犬在224天和357天后失访,2只犬在546天和721天时存活。犬LGL白血病的一个亚组与免疫介导的血细胞减少症相关,并具有独特的临床表现。

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