title: Neutropenia and anaemia associated with T-cell large granular lymphocyte leukaemia responds to fludarabine with minimal toxicity.
abstract: T-cell large granular lymphocyte leukaemia (T-LGL) is a clonal disorder of T cells associated with neutropenia and anaemia. The clinical consequences are recurrent infections and transfusion dependence. The optimum treatment for severely affected patients remains to be defined. Current therapies require long-term administration to maintain an effect. We report the reversal of severe neutropenia and/or anaemia in four patients treated with fludarabine which has been maintained since stopping treatment. The therapeutic side-effects were restricted to one episode of fever not associated with neutropenia. We conclude that fludarabine is effective in T-LGL, may be given safely despite severe neutropenia and induces durable treatment-free remissions.
authors.affiliation: Department of Haematology, John Radcliffe Hospital, Oxford, UK. stern@molbiol.ox.ac.uk
authors.forename: Alexander
authors.initials: A
authors.lastname: Sternberg
authors.forename: Helen
authors.initials: H
authors.lastname: Eagleton
authors.forename: Nithiya
authors.initials: N
authors.lastname: Pillai
authors.forename: Kevin
authors.initials: K
authors.lastname: Leyden
authors.forename: Susan
authors.initials: S
authors.lastname: Turner
authors.forename: Danita
authors.initials: D
authors.lastname: Pearson
authors.forename: Timothy
authors.initials: T
authors.lastname: Littlewood
authors.forename: Chris
authors.initials: C
authors.lastname: Hatton
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000209:etiology*; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015458:Leukemia, T-Cell / Q000150:complications / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009503:Neutropenia / Q000209:etiology*; D014740:Vidarabine / Q000031:analogs & derivatives* / Q000627:therapeutic use*
chemical_list: D000970:Antineoplastic Agents; D014740:Vidarabine; C024352:fludarabine