, Volume 92, Issue 7, pp 985-987
Date: 16 Jan 2013

Clonal T-LGL population mimicking leukemia in Felty’s syndrome—part of a continuous spectrum of T-LGL proliferations?

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Dear Editor,

Large granular lymphocyte leukemia (LGL leukemia) is characterized by expansion of LGL-cells in the peripheral blood and may be associated with the triad rheumatoid arthritis, splenomegaly, and neutropenia [13]. The disease resembles Felty’s syndrome in many aspects, which is usually associated with persistent rheumatoid arthritis [4]. Aberrant signal transducer and activator of transcription 3 (STAT3) signaling was shown to be involved in the pathogenesis of LGL leukemia [5] and the Src homology 2 (SH2) dimerization, and activation domain of STAT3 encoded by exon 20 and 21 of the STAT3 gene is frequently mutated in patients with LGL leukemia. Patients with LGL leukemia and somatic STAT3 mutation are at higher risk for accompanying neutropenia and rheumatoid arthritis [6, 7]. Here, we present and discuss cases of three patients with Felty’s syndrome which show clonal LGL proliferations. In two patients, somatic mutations of the STAT3 gene were found.

Patient 1 was a 36-year ...