T-cell large granular lymphocytic leukemia of donor origin occurring after allogeneic bone marrow transplantation for B-cell lymphoproliferative disorders.
T-cell lymphoproliferative disorders are uncommon occurrences after bone marrow transplantation (BMT). We describe 2 patients in whom a monoclonal T-cell large granular lymphocytosis (T-LGL) developed after allogeneic BMT for B-cell lymphoproliferative disorders. Both patients showed a persistent expansion of CD3+, CD8+, and CD57+ large granular lymphocytes of donor origin with clonally rearranged T-cell receptor gamma genes and no evidence of Epstein-Barr virus-related infection. The manifestations were consistent with T-LGL leukemia as defined by the World Health Organization criteria. In both patients, graft-vs-host disease developed, and 1 had recurrent episodes of cytomegalovirus viremia. The other patient had received a graft from a hepatitis C antibody-positive donor without developing any signs of hepatitis C infection. Both patients remain in complete remission from their B-cell lymphoproliferative disorders and do not have symptoms related to T-LGL leukemia. These data show that T-LGL leukemia should be included as one of the types of posttransplantation lymphoproliferative disorders that can occur after allogeneic BMT for B-cell neoplasms.
Chang
Hong
H
Department of Laboratory Hematology, Princess Margaret Hospital, University Health Network, University of Toronto, ON, Canada.
Kamel-Reid
Suzanne
S
Hussain
Nusrat
N
Lipton
Jeff
J
Messner
Hans A
HA
D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D002999:Clone Cells; D004273:DNA, Neoplasm / Q000032:analysis; D006801:Humans; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000235:genetics / Q000276:immunology / Q000628:therapy*; D015458:Leukemia, T-Cell / Q000209:etiology / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D016692:Receptors, Antigen, T-Cell, gamma-delta / Q000235:genetics; D012074:Remission Induction; D014019:Tissue Donors; D014184:Transplantation, Homologous; D008258:Waldenstrom Macroglobulinemia / Q000235:genetics / Q000276:immunology / Q000628:therapy*
D004273:DNA, Neoplasm; D016692:Receptors, Antigen, T-Cell, gamma-delta