Spontaneous regression of a monoclonal proliferation of large granular lymphocytes associated with reversal of anemia and neutropenia

Blood. 1986 May;67(5):1427-32.

Abstract

A 43-year-old male with a phenotypically homogeneous, expanded subset of T cells presented in 1981 with anemia and neutropenia. The surface antigen phenotype of 99% of the peripheral blood lymphocytes was T3+, T8+, T4-, and they were morphologically large granular lymphocytes (LGL). The same cells comprised 37% of the marrow nucleated cells. Eight months after he presented, the peripheral blood T8+, LGL diminished spontaneously, and the anemia and neutropenia completely resolved. The patient remains hematologically normal as of October 1984. To determine if the T8+, LGL represented a clonal expansion, DNA from peripheral blood lymphocytes collected and cryopreserved when the patient was neutropenic and anemic, and when he was hematologically normal, was analyzed for clonal T-cell antigen receptor gene rearrangements. Using Southern blot analysis, a clonal DNA rearrangement was demonstrated, and this clone diminished but was still demonstrable in peripheral blood lymphocytes collected in 1984. The above observations implicate the expanded T8+, LGL in the pathogenesis of the neutropenia and anemia, yet the exact mechanism remains to be elucidated.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Agranulocytosis / pathology*
  • Anemia / complications
  • Anemia / genetics
  • Anemia / pathology*
  • Antigens, Surface / analysis
  • Blood Cell Count
  • Clone Cells / cytology*
  • DNA / analysis
  • Humans
  • Lymphocytes / cytology*
  • Male
  • Neutropenia / complications
  • Neutropenia / genetics
  • Neutropenia / pathology*
  • Phenotype
  • Receptors, Antigen, T-Cell / genetics
  • Time Factors

Substances

  • Antigens, Surface
  • Receptors, Antigen, T-Cell
  • DNA