[Analysis of clinical characteristics for large granular lymphocytic leukemia]

To explore the clinical and laboratory characteristics for large granular lymphocytic leukemia (LGL).

A total of 35 LGL patients were retrospectively analyzed from March 2004 to May 2013 at our department.

Their median age of diagnosis was 51 years. The anemia-related symptoms included splenomegaly (n = 11, 31.4%). And one patient (2.8%) with a history of rheumatoid arthritis. Anemia was the most frequent hematological abnormality (n = 27, 77.1%). The range of LGL count in peripheral blood was (0.82-23.7) ×10(9)/L. Among them, 19 patients (54.2%) showed the CD3(+)CD57(+) CD56(-)indolent LGL phenotype. Two patients showed complex karyotype. T cell receptor β chain variable region (TCRVβ) analysis was positive in 8 patients. The median overall survival of aggressive LGL patients was significant shorter than that of indolent patient(16 months vs not reached, P = 0.000). Univariate analysis showed the median overall survival of patients with B symptom was significant shorter than that without B symptom (19 vs 45 months, P = 0.039); the median overall survival of patients with thrombocytopenia was significant shorter than that with platelet normal (16 vs 42 months, P = 0.000). Multivariate analysis showed B symptom (P = 0.736) and thrombocytopenia (P = 0.977) at diagnosis were not prognostic factors.

Chinese LGL patient with rheumatoid arthritis is infrequent compared with foreign reports. TCRVβ analysis is important for its diagnosis. The overall survival of aggressive LGL patients is significantly inferior to indolent patients, and need earlier intensive therapy in order to achieve longer survival.