Neutropenia and anaemia associated with T-cell large granular lymphocyte leukaemia responds to fludarabine with minimal toxicity.
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.
Sternberg
Alexander
A
Department of Haematology, John Radcliffe Hospital, Oxford, UK. stern@molbiol.ox.ac.uk
Eagleton
Helen
H
Pillai
Nithiya
N
Leyden
Kevin
K
Turner
Susan
S
Pearson
Danita
D
Littlewood
Timothy
T
Hatton
Chris
C
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*
D000970:Antineoplastic Agents; D014740:Vidarabine; C024352:fludarabine