title: Cell size variations of large granular lymphocyte leukemia: Implication of a small cell subtype of granular lymphocyte leukemia with STAT3 mutations.
abstract: Large granular lymphocyte leukemia (LGL-L) has been morphologically defined as a group of lymphoproliferative disorders, including T-cell large granular lymphocytic leukemia (T-LGL-L), chronic lymphoproliferative disorders of NK cells (CLPD-NK) and aggressive NK cell leukemia. We investigated the morphological features of LGL leukemic cells in 26 LGL-L patients in order to elucidate relationships with current classifications and molecular backgrounds. LGL-L cells were mostly indistinguishable from normal LGL. Patients with STAT3 SH2 domain mutations showed significantly smaller cells compared with patients without STAT3 mutations. Four patients with T-LGL-L showed smaller granular lymphocytes with a median diameter of less than 13μm, which were rarely seen in normal subjects. This small subtype of T-LGL-L was recognized among rather young patients and was associated with D661Y mutations in the STAT3 gene SH2 domain. In addition, all of them showed anemia including two cases with pure red cell aplasia. These results suggest the heterogeneity of T-LGL-L and a specific subtype with small variants of T-LGL-L.
authors.affiliation: Department of Clinical Laboratory Investigation, Graduate School of Medicine, Shinshu University, Matsumoto, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Tanahashi
authors.affiliation: Division of Hematology, Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Japan; Department of Comprehensive Cancer Therapy, Shinshu University School of Medicine, Matsumoto, Japan.
authors.forename: Nodoka
authors.initials: N
authors.lastname: Sekiguchi
authors.affiliation: Department of Laboratory Medicine, Shinshu University Hospital, Matsumoto, Japan.
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Matsuda
authors.affiliation: Department of Laboratory Medicine, Shinshu University Hospital, Matsumoto, Japan.
authors.forename: Yuka
authors.initials: Y
authors.lastname: Takezawa
authors.affiliation: Division of Hematology, Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Japan.
authors.forename: Toshiro
authors.initials: T
authors.lastname: Ito
authors.affiliation: Department of Hematology, Nagano Red Cross Hospital, Nagano, Japan.
authors.forename: Hikaru
authors.initials: H
authors.lastname: Kobayashi
authors.affiliation: Department of Hematology, Nagano Red Cross Hospital, Nagano, Japan.
authors.forename: Naoaki
authors.initials: N
authors.lastname: Ichikawa
authors.affiliation: Division of Hematology, Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Japan.
authors.forename: Sayaka
authors.initials: S
authors.lastname: Nishina
authors.affiliation: Division of Hematology, Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Japan.
authors.forename: Noriko
authors.initials: N
authors.lastname: Senoo
authors.affiliation: Division of Hematology, Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Japan.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Sakai
authors.affiliation: Division of Hematology, Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Japan.
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Nakazawa
authors.affiliation: Department of Clinical Laboratory Investigation, Graduate School of Medicine, Shinshu University, Matsumoto, Japan; Division of Hematology, Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Japan; Department of Biomedical Laboratory Sciences, Shinshu University School of Medicine, Matsumoto, Japan. Electronic address: fumishi@shinshu-u.ac.jp.
authors.forename: Fumihiro
authors.initials: F
authors.lastname: Ishida
mesh_terms: D000328:Adult; D000368:Aged; D000740:Anemia; D048429:Cell Size; D005260:Female; D006801:Humans; D054066:Leukemia, Large Granular Lymphocytic / Q000145:classification / Q000188:drug therapy / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009154:Mutation; D050796:STAT3 Transcription Factor / Q000235:genetics*; D055815:Young Adult
chemical_list: D050796:STAT3 Transcription Factor
keywords: Cytotoxic T cell; Granular lymphocyte; LGL; Large granular lymphocyte leukemia; STAT3 mutation