title: Peripheral T-cell lymphomas with cytotoxic phenotype in patients with chronic lymphocytic leukemia/small lymphocytic lymphoma.
abstract: Chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) is relatively common, and patients occasionally develop other neoplasms; however, patients who develop other types of lymphomas are rare. We encountered 3 patients with CLL/SLL (one 59-y-old man and 2 women aged 56 and 66 y) who developed T-cell lymphomas. Both women developed ALK anaplastic large cell lymphomas (ALCLs), whereas the man developed CD8 peripheral T-cell lymphoma, not otherwise specified. All 3 T-cell lymphomas expressed granzyme B and perforin, indicating a cytotoxic immunophenotype. In 1 case, the first presentation was a lymph nodal composite lymphoma. In the other 2 cases, the T-cell lymphomas arose <1 year after the diagnosis of CLL/SLL and were identified in a lymph node in one case and in the spleen in the other. The patient with a composite lymphoma (SLL/ALK ALCL) was treated and was free of disease at last follow-up, whereas the other 2 patients succumbed to their disease, 1 month and 7 months after the diagnosis of T-cell lymphoma. Peripheral T-cell lymphomas rarely occur in CLL/SLL patients. On the basis of our small series, those with a cytotoxic phenotype appear to be more common in this setting. The occurrence of ALK ALCL in 2 older patients was especially surprising and suggested that CLL/SLL may have played a role in the development of ALCL.
authors.affiliation: *Massachusetts General Hospital †Brigham and Women's Hospital, Boston, MA.
authors.forename: Daniel F
authors.initials: DF
authors.lastname: Boyer
authors.forename: Neal I
authors.initials: NI
authors.lastname: Lindeman
authors.forename: Nancy Lee
authors.initials: NL
authors.lastname: Harris
authors.forename: Judith Ann
authors.initials: JA
authors.lastname: Ferry
mesh_terms: D000368:Aged; D000077548:Anaplastic Lymphoma Kinase; D014408:Biomarkers, Tumor / Q000032:analysis; D017809:Fatal Outcome; D005260:Female; D053804:Granzymes / Q000032:analysis; D006801:Humans; D007150:Immunohistochemistry; D016130:Immunophenotyping; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000201:enzymology / Q000276:immunology* / Q000628:therapy; D017728:Lymphoma, Large-Cell, Anaplastic / Q000737:chemistry / Q000276:immunology* / Q000628:therapy; D016411:Lymphoma, T-Cell, Peripheral / Q000737:chemistry / Q000276:immunology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D054353:Perforin / Q000032:analysis; D010641:Phenotype; D020794:Receptor Protein-Tyrosine Kinases / Q000032:analysis; D013602:T-Lymphocytes, Cytotoxic / Q000737:chemistry / Q000276:immunology*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D014408:Biomarkers, Tumor; D054353:Perforin; C000626173:ALK protein, human; D000077548:Anaplastic Lymphoma Kinase; D020794:Receptor Protein-Tyrosine Kinases; C509213:GZMB protein, human; D053804:Granzymes