title: T-cell large granular lymphocyte proliferation in myelodysplastic syndromes: Clinicopathological features and prognostic significance.
abstract: Inflammatory and immune dysregulation are crucial in the initiation and development of myelodysplastic syndromes (MDS). It is noted that clonal T-cell large granular lymphocyte (T-LGL) proliferation associated with MDS is not uncommon. However, clinicopathological features, and prognostic and predictive value of presence of T-LGL proliferation in MDS patients is not very clear. This study compared 35 MDS patients with T-LGL proliferation with 36 MDS patients without T-LGL proliferation and summarized clinicopathologic features, including peripheral blood LGL cell counts, immunophenotype, T cell receptor gene rearrangement, bone marrow hematopoietic status, and adjuvant immunosuppressive therapy. The peripheral blood CD3+/CD57+ cell counts were significantly different (p<0.01) between the two groups. Notably, on examination of the bone marrow, MDS patients with T-LGL proliferation showed more frequent hypocellularity and/or lineage hypoplasia, particularly erythroid hypoplasia. On survival analysis, no overall difference was noted between MDS patients with T-LGL proliferation and those without T-LGL proliferation, and between the patients who received therapy for LGL and those who did not receive adjuvant therapy for LGL in the same risk group. In conclusion, T-LGL proliferation present in MDS patients can be associated with bone marrow hypocellularity and lineage hypoplasia. Although immunosuppressive therapy to eliminate T-LGL cells is potentially beneficial to the MDS patients with associated T-LGL proliferation, there is no overall survival benefit to the patients who received such treatment.
authors.affiliation: Department of Hematopathology and Laboratory Medicine, United States.
authors.forename: Xiaohui
authors.initials: X
authors.lastname: Zhang
authors.affiliation: Department of Malignant Hematology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, United States.
authors.forename: Lubomir
authors.initials: L
authors.lastname: Sokol
authors.affiliation: Department of Pathology and Laboratory Medicine, University of Rochester Medical Center, Rochester, New York, United States.
authors.forename: John M
authors.initials: JM
authors.lastname: Bennett
authors.affiliation: Department of Hematopathology and Laboratory Medicine, United States.
authors.forename: Lynn C
authors.initials: LC
authors.lastname: Moscinski
authors.affiliation: Department of Malignant Hematology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, United States.
authors.forename: Alan
authors.initials: A
authors.lastname: List
authors.affiliation: Department of Hematopathology and Laboratory Medicine, United States. Electronic address: ling.zhang@moffitt.org.
authors.forename: Ling
authors.initials: L
authors.lastname: Zhang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001853:Bone Marrow / Q000378:metabolism / Q000473:pathology; D049109:Cell Proliferation; D017024:Chemotherapy, Adjuvant; D016208:Databases, Factual; D005260:Female; D006410:Hematopoiesis; D006801:Humans; D007165:Immunosuppression Therapy; D018655:Lymphocyte Count; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000097:blood* / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology; D011379:Prognosis; D013601:T-Lymphocytes / Q000378:metabolism* / Q000473:pathology
keywords: Myelodysplastic syndromes; Prognosis; T-cell large granular lymphocyte proliferation