title: [Successful treatment of T-cell prolymphocytic leukemia (T-PLL) with fludarabine monophosphate].
abstract: We report a 79-year-old woman with T-cell prolymphocytic leukemia (T-PLL) who was successfully treated with fludarabine monophosphate. She was admitted to our hospital because of dyspnea on effort. On admission, anemia and hepatosplenomegaly were apparent but lymphadenopathy was absent. Peripheral blood examination showed anemia and leukocytosis with 29.5% abnormal lymphocytes. The bone marrow was infiltrated with 84.1% abnormal lymphocytes. The nucleolus was visible in some of these abnormal cells. These cells were positive for CD2, CD3, CD4, CD5, CD7, CD38, CD52, and negative for CD8, CD10, CD19, CD20, CD25, CD56. Based on these findings, she was diagnosed as having T-PLL. Therapy with oral cyclophosphamide (50 mg/day) was started, but was discontinued because of agranulocytosis. Then, she received intravenous fludarabine monophosphate (30 mg/day) on days 1-5 every four to five weeks. The reticulocyte count increased gradually, and she became free from red cell transfusions. Unfortunately, she finally died from massive gastro intestinal hemorrhage, but T-PLL was well controlled at the time of death.
authors.affiliation: Department of Hematology, Shizuoka City Shizuoka Hospital.
authors.forename: Akinori
authors.initials: A
authors.lastname: Maeda
authors.forename: Kazuya
authors.initials: K
authors.lastname: Iwai
authors.forename: Takafumi
authors.initials: T
authors.lastname: Ishibashi
mesh_terms: D000368:Aged; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage*; D004334:Drug Administration Schedule; D017809:Fatal Outcome; D005260:Female; D006471:Gastrointestinal Hemorrhage; D006801:Humans; D007262:Infusions, Intravenous; D015461:Leukemia, Prolymphocytic, T-Cell / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology; D016896:Treatment Outcome; D001084:Vidarabine Phosphate / Q000008:administration & dosage / Q000031:analogs & derivatives*
chemical_list: D000964:Antimetabolites, Antineoplastic; D001084:Vidarabine Phosphate; C042382:fludarabine phosphate