title: Very long-lasting remission of refractory T-large granular lymphocytes leukemia and myeloma by lenalidomide treatment.
abstract: BACKGROUND
  Large granular lymphocyte leukemias (LGLLs) represent a spectrum of biologically distinct lymphoproliferative diseases originating from either mature T cells (CD3+) or natural killer (NK) cells (CD3-). Both T-cell and NK-cell LGL leukemia can manifest as indolent or aggressive neoplasia. These rare lymphoproliferative disorders are often associated with autoimmune diseases and impaired hematopoiesis. Symptomatic patients are treated with immunosuppressive drugs. The co-association of T-LGLL with clonal B-cell disorders is reported in more than 10% of patients.
  
  
  METHODS
  We describe the case of a 57-yr-old white male patient with no history of autoimmune disorders, with refractory T-LGLL and myeloma who was treated with bortezomib and subsequently with lenalidomide. After 30 months of on-going lenalidomide therapy, the patient is in partial remission from myeloma and in continuous complete hematological remission from T-LGLL.
  
  
  CONCLUSIONS
  As far as we know, this is the first report of a patient with refractory T-LGLL treated with bortezomib and lenalidomide. As refractory T-LGLL is a challenging condition, we think that lenalidomide and bortezomib deserve further investigation.
authors.affiliation: Department of Hematology, AO Sant'Andrea, La Sapienza University, Rome, Italy. sabrina.pelliccia@virgilio.it
authors.forename: Sabrina
authors.initials: S
authors.lastname: Pelliccia
authors.forename: Arianna
authors.initials: A
authors.lastname: Di Napoli
authors.forename: Virginia
authors.initials: V
authors.lastname: Naso
authors.forename: Eleonora
authors.initials: E
authors.lastname: Alma
authors.forename: Caterina
authors.initials: C
authors.lastname: Rebecchini
authors.forename: Maria C
authors.initials: MC
authors.lastname: Cox
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001853:Bone Marrow / Q000473:pathology; D001897:Boronic Acids / Q000627:therapeutic use; D000069286:Bortezomib; D006801:Humans; D000077269:Lenalidomide; D054066:Leukemia, Large Granular Lymphocytic / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy*; D011719:Pyrazines / Q000627:therapeutic use; D012074:Remission Induction; D013792:Thalidomide / Q000031:analogs & derivatives* / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D001897:Boronic Acids; D011719:Pyrazines; D013792:Thalidomide; D000069286:Bortezomib; D000077269:Lenalidomide
keywords: bortezomib; large granular lymphocyte leukemia; lenalidomide; myeloma