title: Severe neutropenia in T-large granular lymphocyte leukemia corrected by intensive immunosuppression.
abstract: Optimum treatment of severe neutropenia, a major factor for morbidity and mortality in T-large granular lymphocyte (LGL) leukemia, is undefined. We observed a rapid improvement of the neutrophil count in a patient with T-LGL leukemia and severe neutropenia after the combined administration of antilymphocyte-globulin (ALG), cyclosporin A, prednisone, and granulocyte colony-stimulating factor (G-CSF). Although G-CSF treatment was terminated after 7 days, the neutrophil count has persisted above 1.0 x 10(9)/1 for up to 6 months now. Oral methotrexate is given continuously as treatment for T-LGL leukemia. The response to this immunosuppressive regimen suggests a T-cell-mediated mechanism as the underlying cause for neutropenia in T-LGL leukemia.
authors.affiliation: Department of Internal Medicine, Kantonsspital Basel, Switzerland.
authors.forename: M J
authors.initials: MJ
authors.lastname: Bargetzi
authors.forename: M
authors.initials: M
authors.lastname: Wortelboer
authors.forename: T
authors.initials: T
authors.lastname: Pabst
authors.forename: L
authors.initials: L
authors.lastname: Franscini
authors.forename: H
authors.initials: H
authors.lastname: Gudat
authors.forename: A
authors.initials: A
authors.lastname: Tichelli
authors.forename: A
authors.initials: A
authors.lastname: Tobler
authors.forename: B
authors.initials: B
authors.lastname: Speck
authors.forename: A
authors.initials: A
authors.lastname: Gratwohl
mesh_terms: D006801:Humans; D007165:Immunosuppression Therapy; D007945:Leukemia, Lymphoid / Q000628:therapy*; D015458:Leukemia, T-Cell / Q000628:therapy*; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D009503:Neutropenia / Q000473:pathology / Q000628:therapy*; D009504:Neutrophils / Q000473:pathology