BACKGROUND: Large granular lymphocyte leukemias (LGLLs) represent a spectrum of biologically distinct lymphoproliferative diseases originating from either mature T cells (CD3+) or natural killer (NK) cells (CD3-). Both T-cell and NK-cell LGL leukemia can manifest as indolent or aggressive neoplasia. These rare lymphoproliferative disorders are often associated with autoimmune diseases and impaired hematopoiesis. Symptomatic patients are treated with immunosuppressive drugs. The co-association of T-LGLL with clonal B-cell disorders is reported in more than 10% of patients. CASE PRESENTATION: We describe the case of a 57-yr-old white male patient with no history of autoimmune disorders, with refractory T-LGLL and myeloma who was treated with bortezomib and subsequently with lenalidomide. After 30 months of on-going lenalidomide therapy, the patient is in partial remission from myeloma and in continuous complete hematological remission from T-LGLL. CONCLUSIONS: As far as we know, this is the first report of a patient with refractory T-LGLL treated with bortezomib and lenalidomide. As refractory T-LGLL is a challenging condition, we think that lenalidomide and bortezomib deserve further investigation.
BACKGROUND: Large granular lymphocyte leukemias (LGLLs) represent a spectrum of biologically distinct lymphoproliferative diseases originating from either mature T cells (CD3+) or natural killer (NK) cells (CD3-). Both T-cell and NK-cell LGL leukemia can manifest as indolent or aggressive neoplasia. These rare lymphoproliferative disorders are often associated with autoimmune diseases and impaired hematopoiesis. Symptomatic patients are treated with immunosuppressive drugs. The co-association of T-LGLL with clonal B-cell disorders is reported in more than 10% of patients. CASE PRESENTATION: We describe the case of a 57-yr-old white male patient with no history of autoimmune disorders, with refractory T-LGLL and myeloma who was treated with bortezomib and subsequently with lenalidomide. After 30 months of on-going lenalidomide therapy, the patient is in partial remission from myeloma and in continuous complete hematological remission from T-LGLL. CONCLUSIONS: As far as we know, this is the first report of a patient with refractory T-LGLL treated with bortezomib and lenalidomide. As refractory T-LGLL is a challenging condition, we think that lenalidomide and bortezomib deserve further investigation.
Authors: Zachary Braunstein; Eric McLaughlin; Miguel Ruiz; Lai Wei; Naresh Bumma; Don Benson; Srinivas Devarakonda; Maria Chaudhry; Abdullah Khan; Francesca Cottini; Walter Hanel; Robert Baiocchi; Catherine Chung; Daniel Addison; Nina Couette; Alexa Meara; Wael Jarjour; Pierluigi Porcu; Anjali Mishra; John C Reneau; Ashley E Rosko; Jonathan E Brammer Journal: Front Oncol Date: 2022-04-29 Impact factor: 5.738
Authors: Jani Huuhtanen; Dipabarna Bhattacharya; Tapio Lönnberg; Matti Kankainen; Cassandra Kerr; Jason Theodoropoulos; Hanna Rajala; Carmelo Gurnari; Tiina Kasanen; Till Braun; Antonella Teramo; Renato Zambello; Marco Herling; Fumihiro Ishida; Toru Kawakami; Marko Salmi; Thomas Loughran; Jaroslaw P Maciejewski; Harri Lähdesmäki; Tiina Kelkka; Satu Mustjoki Journal: Nat Commun Date: 2022-04-11 Impact factor: 17.694