Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Sep 16, 2021; 9(26): 7818-7824
Published online Sep 16, 2021. doi: 10.12998/wjcc.v9.i26.7818
Treatment for CD57-negative γδ T-cell large granular lymphocytic leukemia with pure red cell aplasia: A case report
Ping-Ping Xiao, Xu-Yan Chen, Zhi-Gao Dong, Jin-Mei Huang, Qing-Qing Wang, Yong-Quan Chen, Yi Zhang
Ping-Ping Xiao, Xu-Yan Chen, Zhi-Gao Dong, Jin-Mei Huang, Qing-Qing Wang, Yong-Quan Chen, Yi Zhang, Department of Hematology and Rheumatology, The Second Affiliated Hospital of Xiamen Medical College, Xiamen 361021, Fujian Province, China
Author contributions: Xiao PP collected the patient’s clinical data and drafted and revised the manuscript; Chen XY, Dong ZG, and Huang JM managed the patient in the hospital; Wang QQ, Chen YQ, and Zhang Y collected the laboratory data; all authors approved the final manuscript.
Supported by Xiamen Medical and Health Guidance Project, No. 3502Z20199137; Fujian Medical and Health Training Project for Young and Middle-aged Backbone Talents, No. 2020GGB068; and Educational and Scientific Research Program for Young and Middle-Aged Teachers of Fujian Province, No. JAT190838.
Informed consent statement: Written informed consent was obtained from the patient for the inclusion of her clinical details for publication.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ping-Ping Xiao, MD, Associate Chief Physician, Department of Hematology and Rheumatology, The Second Affiliated Hospital of Xiamen Medical College, No. 566 Shengguang Road, Jimei District, Xiamen 361021, Fujian Province, China. xiaopp0026@163.com
Received: February 23, 2021
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
Abstract
BACKGROUND

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).

CASE SUMMARY

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.

CONCLUSION

The treatment of CD57-negative γδT-LGLL with PRCA with cyclophosphamide helps to improve prognosis.

Keywords: Large granular lymphocytic leukemia, Pure red cell aplasia, Aplastic anemia, γδ T-cell, Cyclophosphamide, Case report

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.