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A screening method with lymphocyte percentage and proportion of granular lymphocytes in the peripheral blood for large granular lymphocyte (LGL) leukemia

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Abstract

Large granular lymphocyte leukemia (LGL-L) is defined morphologically as a group of lymphoproliferative disorders, including T-cell large granular lymphocytic leukemia (T-LGL-L), chronic lymphoproliferative disorders of NK cells (CLPD-NK), and aggressive NK cell leukemia. We investigated the morphological features of LGL leukemic cells in LGL-L patients to identify screening methods best suited to application in daily clinical practice. LGL leukemic cells were mostly indistinguishable from normal LGL; however, we developed a simplified approach to distinguishing among these cells, in which lymphocyte  % and the proportion of granular lymphocytes among lymphocytes (GL %) can serve as parameters at the cut-off values of 52 and 50 %, respectively. We confirmed the accuracy of these methods in validation groups. It may be useful to evaluate GL % to screen for LGL-L using a cut-off threshold of 50 when Lym % exceeds 52 in the peripheral blood examination in cases in which LGL-L is suspected in daily practice while keeping clinical context and the coefficient of variation of these parameters under consideration.

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References

  1. Loughran TP Jr. Clonal diseases of large granular lymphocytes. Blood. 1993;82:1–14.

    PubMed  Google Scholar 

  2. Oshimi K. Granular lymphocyte proliferative disorders: report of 12 cases and review of the literature. Leukemia. 1988;2:617–27.

    CAS  PubMed  Google Scholar 

  3. Zhang D, Loughran TP Jr. Large granular lymphocytic leukemia: molecular pathogenesis, clinical manifestations, and treatment. Hematol Am Soc Hematol Educ Progr. 2012;2012:652–9.

    Google Scholar 

  4. Dearden C. Large granular lymphocytic leukaemia pathogenesis and management. Br J Haematol. 2011;152:273–83.

    Article  PubMed  Google Scholar 

  5. Bockorny B, Dasanu CA. Autoimmune manifestations in large granular lymphocyte leukemia. Clin Lymphoma Myeloma Leuk. 2012;12:400–5.

    Article  CAS  PubMed  Google Scholar 

  6. Chan WC, Foucar K, Morice WG, Catovsky D. T-cell large granular lymphocytic leukemia. In: Swerdlow SH, Campo E, Harris NL, Jaffe ES, Pileri SA, Stein H, et al., editors. WHO Classification of tumours of haematopoietic and lymphoid tissues. Lyon: IARC; 2008. p. 272–3.

    Google Scholar 

  7. Villamor N, Morice WG, Chan WC, Foucar K. Chronic lymphoproliferative disorders of NK cells. In: Swerdlow SH, Campo E, Harris NL, Jaffe ES, Pileri SA, Stein H, et al., editors. WHO classification of tumours of haematopoietic and lymphoid tissues. Lyon: IARC; 2008. p. 274–5.

    Google Scholar 

  8. Chan JKC, Jaffe ES, Raffeld E, Ko Y-H. Aggressive NK-cell leukaemia. In: Swerdlow SH, Campo E, Harris NL, Jaffe ES, Pileri SA, Stein H, et al., editors. WHO classification of tumours of haematopoietic and lymphoid tissues. Lyon: IARC; 2008. p. 276–7.

    Google Scholar 

  9. Ishida F, Ko YH, Kim WS, Suzumiya J, Isobe Y, Oshimi K, et al. Aggressive natural killer cell leukemia: therapeutic potential of l-asparaginase and allogeneic hematopoietic stem cell transplantation. Cancer Sci. 2012;103:1079–83.

    Article  CAS  PubMed  Google Scholar 

  10. Kawahara S, Sasaki M, Isobe Y, Ando J, Noguchi M, Koike M, et al. Clinical analysis of 52 patients with granular lymphocyte proliferative disorder (GLPD) showed frequent anemia in indolent T-cell GLPD in Japan. Eur J Haematol. 2009;82:308–14.

    Article  CAS  PubMed  Google Scholar 

  11. Kwong YL, Au WY, Leung AY, Tse EW. T-cell large granular lymphocyte leukemia: an Asian perspective. Ann Hematol. 2010;89:331–9.

    Article  PubMed  Google Scholar 

  12. Zhou F, Chan WC. T-cell large granular lymphocytic leukemia. In: Jaffe ES, Harris NL, Vardiman JW, Campo E, Arber DA, editors. Hematopathology. St. Louis: Elsevier; 2011. p. 506–12.

    Chapter  Google Scholar 

  13. O’Malley DP. T-cell large granular leukemia and related proliferations. Am J Clin Pathol. 2007;127:850–9.

    Article  PubMed  Google Scholar 

  14. Lamy T, Loughran TP Jr. How I treat LGL leukemia. Blood. 2011;117:2764–74.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Tanahashi T, Sekiguchi N, Matsuda K, Takezawa Y, Ito T, Kobayashi H, et al. Cell size variations of large granular lymphocyte leukemia: implication of a small cell subtype of granular lymphocyte leukemia with STAT3 mutations. Leuk Res. 2016;45:8–13.

    Article  CAS  PubMed  Google Scholar 

  16. Kelemen E, Gergely P, Lehoczky D, Triska E, Demeter J, Vargha P. Permanent large granular lymphocytosis in the blood of splenectomized individuals without concomitant increase of in vitro natural killer cell cytotoxicity. Clin Exp Immunol. 1986;63:696–702.

    CAS  PubMed  PubMed Central  Google Scholar 

  17. Oshimi K. Leukemia and lymphoma of natural killer lineage cells. Int J Hematol. 2003;78:18–23.

    Article  PubMed  Google Scholar 

  18. Kanda Y. Investigation of the freely available easy-to-use software ‘EZR’ for medical statistics. Bone Marrow Transpl. 2013;48:452–8.

    Article  CAS  Google Scholar 

  19. Semenzato G, Zambello R, Starkebaum G, Oshimi K, Loughran TP Jr. The lymphoproliferative disease of granular lymphocytes: updated criteria for diagnosis. Blood. 1997;89:256–60.

    CAS  PubMed  Google Scholar 

  20. Ishida F, Matsuda K, Sekiguchi N, Makishima H, Taira C, Momose K, et al. STAT3 gene mutations and their association with pure red cell aplasia in large granular lymphocyte leukemia. Cancer Sci. 2014;105:342–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Dhodapkar MV, Li CY, Lust JA, Tefferi A, Phyliky RL. Clinical spectrum of clonal proliferations of T-large granular lymphocytes: a T-cell clonopathy of undetermined significance? Blood. 1994;84:1620–7.

    CAS  PubMed  Google Scholar 

  22. Morice WG, Kurtin PJ, Tefferi A, Hanson CA. Distinct bone marrow findings in T-cell granular lymphocytic leukemia revealed by paraffin section immunoperoxidase stains for CD8, TIA-1, and granzyme B. Blood. 2002;99:268–74.

    Article  CAS  PubMed  Google Scholar 

  23. Morice WG, Jevremovic D, Olteanu H, Roden A, Nowakowski G, Kroft S, et al. Chronic lymphoproliferative disorder of natural killer cells: a distinct entity with subtypes correlating with normal natural killer cell subsets. Leukemia. 2010;24:881–4.

    Article  CAS  PubMed  Google Scholar 

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Acknowledgments

We appreciate Ms. Haruka Nakamura and Ms. Nana Suzuki (School of Health Sciences, Shinshu University, Matsumoto, Japan) for their technical assistances. We are also grateful to Dr. Akio Saito (Fujioka General Hospital, Fujioka, Japan), Dr.Yasunobu Takeoka (Saiseikai Nakatsu Hospital, Osaka, Japan) and Dr. Shinya Sato (Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan) for providing clinical data.

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Authors and Affiliations

  1. Department of Clinical Laboratory Investigation, Graduate School of Medicine, Shinshu University, Matsumoto, Japan

    Takahiro Tanahashi & Fumihiro Ishida

  2. Division of Hematology, Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Japan

    Nodoka Sekiguchi, Toshiro Ito, Hideyuki Nakazawa & Fumihiro Ishida

  3. Department of Comprehensive Cancer Therapy, Shinshu University School of Medicine, Matsumoto, Japan

    Nodoka Sekiguchi

  4. Department of Laboratory Medicine, Shinshu University Hospital, Matsumoto, Japan

    Kazuyuki Matsuda

  5. Division of Gastroenterology, Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Japan

    Akihiro Matsumoto

  6. Department of Biomedical Laboratory Sciences, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, 390-8621, Japan

    Fumihiro Ishida

Authors
  1. Takahiro Tanahashi
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  2. Nodoka Sekiguchi
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  3. Kazuyuki Matsuda
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  4. Akihiro Matsumoto
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  5. Toshiro Ito
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  6. Hideyuki Nakazawa
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  7. Fumihiro Ishida
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Correspondence to Fumihiro Ishida.

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Tanahashi, T., Sekiguchi, N., Matsuda, K. et al. A screening method with lymphocyte percentage and proportion of granular lymphocytes in the peripheral blood for large granular lymphocyte (LGL) leukemia. Int J Hematol 105, 87–91 (2017). https://doi.org/10.1007/s12185-016-2092-1

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  • DOI: https://doi.org/10.1007/s12185-016-2092-1

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