T-cell large granular lymphocytic leukemia occurring after autologous peripheral blood stem cell transplantation

Area of Science:

• Hematology
• Oncology
• Immunology

Background:

• Angioimmunoblastic lymphoma (AIBL) is an aggressive non-Hodgkin lymphoma.
• Autologous peripheral blood stem cell transplantation (aHSCT) is a treatment option for relapsed or refractory AIBL.
• Post-transplant lymphoproliferative disorders (PTLDs) are known complications, often aggressive and associated with allogeneic transplantation.

Observation:

• A 61-year-old male in remission from AIBL developed asymptomatic large granular lymphocytosis (LGL) one month after aHSCT.
• The LGL cells exhibited a CD3+CD8+CD56-CD57+ immunophenotype.
• The patient maintained complete remission from AIBL with a persistent, indolent LGL.
• Lymphocyte counts ranged from 5-15 x 10(9)/l.

Findings:

• The development of T-cell large granular lymphocytic leukemia (T-LGL) post-aHSCT is reported.
• The observed T-LGL was chronic and indolent in its disease course.
• This case contrasts with typical aggressive PTLDs seen after allogeneic transplantation.

Implications:

• This case suggests that chronic, indolent T-LGL can be a complication following autologous stem cell transplantation.
• It highlights the importance of monitoring for diverse lymphoproliferative disorders post-transplant, regardless of transplant type.
• Further research is needed to understand the mechanisms and long-term outcomes of T-LGL after aHSCT.