T-cell large granular lymphocytic leukemia with a STAT3 mutation successfully treated with cord blood transplantation

Intern Med. 2024 Aug 28. doi: 10.2169/internalmedicine.4076-24. Online ahead of print.

Abstract

A 64-year-old woman presented with agranulocytosis, anemia, and bacteremia, leading to a diagnosis of T-cell large granular lymphocytic leukemia (T-LGLL). A molecular analysis identified a signal transducer and activator of transcription 3 (STAT3) Y640F variant. Initial treatment with cyclophosphamide and prednisolone did not improve her condition, but serious infections were observed. The patient underwent cord blood transplantation (CBT) after preconditioning with fludarabine, busulfan, and total body irradiation, yielding a STAT3 Y640F variant disappearance, based on allele-specific quantitative polymerase chain reaction (AS-qPCR). In this case, CBT is a promising refractory T-LGLL treatment option, and the STAT3 Y640F variant AS-qPCR is a T-LGLL activity marker.

Keywords: T-cell large granular lymphocytic leukemia; allele-specific quantitative PCR; cord blood transplantation; signal transducer and activator of transcription 3 (STAT3).