Published online Sep 16, 2021. doi: 10.12998/wjcc.v9.i26.7818
Peer-review started: February 23, 2021
First decision: June 15, 2021
Revised: June 28, 2021
Accepted: July 28, 2021
Article in press: July 28, 2021
Published online: September 16, 2021
T-cell large granular lymphocytic leukemia (T-LGLL) is a rare type of aplastic anemia with diverse clinical manifestations. Concomitant diseases are often present at the first manifestation. We describe the treatment of a patient with CD57-negative γδT-LGLL with pure red cell aplasia (PRCA).
A 34-year-old woman with a 20-year history of anemia visited our hospital owing to severe dizziness and was admitted. Her condition was diagnosed as CD57-negative γδT-LGLL with PRCA through bone marrow cytology, bone marrow pathology, bone marrow flow cytometry, bone marrow multiplex polymerase chain reaction combined with fluorescent fragment analysis, and other tests. Treatment with prednisone, methotrexate, and subcutaneous erythropoietin did not significantly change her hemoglobin level. After treatment with oral cyclophosphamide for 3 mo, her hemoglobin level increased to approximately 100 g/L. After 5 mo of treatment, the patient could perform activities of daily living independently.
The treatment of CD57-negative γδT-LGLL with PRCA with cyclophosphamide helps to improve prognosis.
Core Tip: This case report presents a rare case of γδ T-cell large granular lymphocytic leukemia with pure red cell aplasia. A 34-year-old woman was admitted to our hospital with a 20-year history of anemia. Upon investigation, it was discovered that our patient had an atypical immunophenotype. Cyclophosphamide was added to her treatment, and other drugs, such as prednisone, methotrexate, and erythropoietin, were discontinued. Her hemoglobin level increased to 100 g/L within 3 mo. We believe that our study makes a significant contribution to the literature because we report on a favorable prognosis in our patient.