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Large Granular Lymphocytes and Large Granular Lymphocytic Leukemia: A Real-World Case-Control Study
Chenxi Liu1,2, Yan Liu1,2, Yishuang Li1,2
1State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, P. R. China.
Insights
Peripheral blood smear examination effectively screens for large granular lymphocyte leukemia (LGLL). A threshold of 24% large granular lymphocytes (LGLs) aids in LGLL patient identification.
Area of Science:
- Hematology
- Oncology
Background:
- Large granular lymphocyte leukemia (LGLL) is a rare clonal lymphoproliferative disorder.
- Accurate diagnosis relies on identifying increased large granular lymphocytes (LGLs) in peripheral blood.
Purpose of the Study:
- To compare LGL counts in healthy donors versus LGLL patients.
- To evaluate peripheral blood smear sensitivity for LGLL diagnosis.
Main Methods:
- Retrospective analysis of 391 healthy donors and 53 LGLL patients.
- Comparison of peripheral blood smear and flow cytometry results.
- Receiver Operating Characteristic (ROC) curve analysis to determine diagnostic thresholds.
Main Results:
- Significant differences in LGL proportion and absolute count between healthy donors and LGLL patients (P<0.001).
- Peripheral blood smear and flow cytometry showed comparable diagnostic performance.
- A 24% LGL proportion was identified as a cutoff value for LGLL screening.
Conclusions:
- Peripheral blood smear examination is a valuable tool for initial LGLL screening.
- Established thresholds (0.5×10⁹/L LGL absolute count and 24% LGL proportion) can effectively screen LGLL patients.
Objective:
This study aimed to compare differences in peripheral blood large granular lymphocytes (LGLs) between healthy donors and patients with large granular lymphocyte leukemia (LGLL), and explore methods to boost the sensitivity of peripheral blood smear examination for LGLL identification.
Materials And Methods:
We retrospectively analyzed 391 healthy donors and 53 LGLL patients from 2023 to 2024.
Results:
Results showed significant differences in LGL proportion, absolute count and its proportion in lymphocytes between the two groups (all P<0.001). There was no significant difference between smear and flow cytometric results. ROC curve analysis determined 24% LGL proportion as the cutoff value.
Conclusion:
Peripheral blood smear can be used for initial LGLL screening, and the thresholds of 0.5×10⁹/L LGL absolute count and 24% LGL proportion effectively screen LGLL patients.
