Development of rheumatoid arthritis after treatment of large granular lymphocyte leukemia with deoxycoformycin.
The association of T-cell large granular lymphocyte (LGL) leukemia and rheumatoid arthritis is well described and it is now recognized that these patients and patients with Felty's syndrome represent different aspects of a single disease process. Most patients have rheumatoid arthritis at the time of diagnosis of LGL leukemia. This is the first detailed report of the development of rheumatoid arthritis after the diagnosis and treatment of LGL leukemia as well as the first report of rheumatoid arthritis that occurred in association with deoxycoformycin treatment. It is likely that the beneficial sustained normalization of neutrophil counts as a result of deoxycoformycin treatment played a significant role in the development of this complication. Hematological improvement occurred despite molecular genetic evidence of persistence of the abnormal T-cell clone. The role of the clonally expanded T cells in the pathogenesis of neutropenia and rheumatoid arthritis is discussed.
Yoe
J
J
Lombardi Cancer Center, Georgetown University Medical Center, Washington, DC, USA.
Gause
B L
BL
Curti
B D
BD
Longo
D L
DL
Bagg
A
A
Kopp
W C
WC
Janik
J E
JE
D000903:Antibiotics, Antineoplastic / Q000009:adverse effects* / Q000627:therapeutic use; D017322:Clinical Trials, Phase II as Topic; D002999:Clone Cells; D005258:Felty Syndrome / Q000139:chemically induced* / Q000473:pathology; D015329:Gene Rearrangement, T-Lymphocyte; D019672:Genes, T-Cell Receptor / Q000235:genetics; D015804:HLA-DR4 Antigen / Q000235:genetics / Q000276:immunology; D006650:Histocompatibility Testing; D006801:Humans; D007945:Leukemia, Lymphoid / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009503:Neutropenia / Q000188:drug therapy / Q000276:immunology / Q000473:pathology; D015649:Pentostatin / Q000009:adverse effects* / Q000627:therapeutic use; D016133:Polymerase Chain Reaction
D000903:Antibiotics, Antineoplastic; D015804:HLA-DR4 Antigen; D015649:Pentostatin