New aggressive variant of suppressor/cytotoxic T-CLL

Three cases of CD8+ CLL are reported. The patients are young (28, 18, 27 years old). The leukemia cells are predominantly small lymphocytes with irregular nuclei bearing notches and lobations. Cytoplasmic azurophilic granules are absent. Cytochemistry shows periodic acid-Schiff granular, alpha-naphthylacetate esterase focal, and acid phosphatase focal/granular positivities. Immunophenotypically cells are CD2+, CD3+, and CD8+ and lack CD4 as well as B-cell and NK cell antigens. All patients died within 20, 16, and 9 months, respectively. The clinicopathologic features of these cases differ clearly from those of the CD8+ CLL with azurophilic granules. These three cases represent a morphologically distinctive and more aggressive variant of CD8+ CLL.