T-cell Large Granular Lymphocytic Leukemia Manifesting in Patients with HIV-1 Infection: Cases Series and Review of the Literature
Main Article Content
Keywords
T-cell LGLL, HIV-1, AIDS, clonal, large granular lymphocyte, leukemia
Abstract
We report five patients with human immunodeficiency virus-1/acquired immunodeficiency syndrome (HIV-1/AIDS) who developed T-cell large granular lymphocytic leukemia (T-LGLL). None of the patients fulfilled criteria for diagnosis of diffuse infiltrative lymphocyte syndrome (DILS) or HIV-associated CD8+ lymphocytosis syndrome at the time of diagnosis of LGLL. The immunophenotype of malignant T-cells was identical in three patients with co-expression of CD3, CD8, CD57, and T-cell receptor (TCR) alpha/beta. Three out of five patients were also diagnosed with clonal disorders of B-cell origin including diffuse large B-cell lymphoma, Burkitt’s lymphoma, and monoclonal gammopathy of undetermined significance (MGUS). Two patients developed cytopenias due to T-LGLL prompting initiation of therapy. Our study suggests that chronic viral infection with HIV can contribute to evolution of T-LGLL. Clinical and laboratory characteristics of T-LGLL associated with HIV-1/AIDS resemble those of immunocompetent patients.
Downloads
Download data is not yet available.
Abstract 2086
PDF Downloads 621
HTML Downloads 219
References
Sokol L, Loughran TP Jr. Large granular lymphocyte leukemia. Oncologist. 2006 Mar;11(3):263-73.
Van den Bergh M., Isenalumhe L., Wang E., et al. A single institutional experience of 261 patients with large granular lymphocytic leukemia. J Clin Oncol. 2017; 35(15 Supplement): 7555.
Pulik M, Lionnet F, Genet P, Petitddier C, Jary L, Fourcade C: CD3+CD8+CD56- clonal large granular lymphocyte leukaemia and HIV infection. Br J Haematol 1997;98:444-445.
Ghali V, Casgtella A, Louis-Charles A, Agranovsky E, Croxson ST: Expansion of large granular lymphocytes (natural killer cells) with limited antigen expression (CD2+, CD3-, CD4-, CD8-, CD16+, NKH-1) in a human immunodeficiency virus-positive homosexual man. Cancer 1990;65:2243-2247.
Moir S, Chun TW, Fauci AS. Pathogenic mechanisms of HIV disease. Annu Reve Pathol 2011;6:223-248.
Diamond C, Taylor TH, Aboumrad T, et al. Changes in acquired immunodeficiency syndrome-related non-Hodgkin lymphoma in the era of highly active antiretroviral therapy: incidence, presentation, treatment, and survival. Cancer 2006;106:128–35.
Lim ST, Karim R, Tulpule A et al. Prognostic factors in HIV-related diffuse large-cell lymphoma: before versus after highly active antiretroviral therapy. J Clin Oncol 2005;23:8477-8482. Epub 2005 Oct 17.
Arzoo KK, Bu X, Espina BM, Seneviratne L, Nathwani B, Levine AM. T-cell lymphoma in HIV-infected patients. J Acquir Immune Defic Syndr 2004;15:1020-1027.
Collins JA, Hernández AV, Hidalgo JA, Villena J, Sumire J, Delgado V, Salazar R. High proportion of T-cell systemic non-Hodgkin lymphoma in HIV-infected patients in Lima, Peru. A Acquir Immune Defic Syndr 2005;40:558-564.
Brugnoni D, Prati E, Cattaneo R, et al. The primary response to HIV infection is characterized by an expansion of activated CD8+CD28- cells. AIDS 1996;10-104-106.
Smith PR, Cavenagh JD, Milne T, Howe D, Wilkes SJ, Sinnott P, Forster GE, Helbert M: Benign monoclonal expansion of CD8+ lymphocytes in HIV infection. J Clin Pathol 2000;53:177-181.
Itescu S, Brancato LJ, Winchestger R: A sicca syndrome in HIV infection: association with HLA-DR5 and CD8 lymphocytosis. Lancet 1989;8661:466-468.
Basu D, Williams FM, Ahn CW, Reveille JD. Changing Spectrum of the Diffuse Infiltrative Lymphocytosis Syndrome. Arhtritis&Rheumatism (Arthritis Care&Research)2006;55:466-472.
Itescu S, Rose S, Dwyer E and Winchester R: Certain HLA-DR5 and –DR6 major histocompatibility complex class II alleles are associated with a CD8 lymphocytic host response to human immunodeficiency virus type 1 characterized by low lymphocyte viral strain heterogeneity and slow disease progression. Proc Natl Acad Sci USA 1994; 91;11472-76.
Ghrenassia, Etienne, Louise Roulin, Aude Aline-Fardin, Christophe Marzac, Frederic Feger, Julie Gay, Jerome Pacanowski, Alexandre Hertig, and Paul Coppo. "The Spectrum of Chronic CD8 T-Cell Expansions: Clinical Features in 14 Patients." PLoS ONE 9.3 (2014): n. pag. Web.
Viny AD, Lichtin A, Pohlman et al. Chronic B-cell dyscrasias are an important clinical feature of T-LGL leukemia. Leuk Lymphoma 2008;49:932-938.
Isenalumhe L., Van den Bergh M., Wang E., et al. Frequency of additional malignancies in patients with large granular lymphocytic leukemia (LGLL): A single Institutional experience. J Clin Oncol. 2017; 35(8 Supplement): 7542.
Van den Bergh M., Isenalumhe L., Wang E., et al. A single institution analysis of patients with dual diagnosis of T-cell large granular lymphocytic leukemia and either a plasma cell and/or a B-cell lymphoproliferative Disorder. Clin Lymphoma Myeloma Leuk. 2016; 16 (2 Supplement): 117.
Van den Bergh M., Isenalumhe L., Wang E., et al. A single institutional experience of 261 patients with large granular lymphocytic leukemia. J Clin Oncol. 2017; 35(15 Supplement): 7555.
Pulik M, Lionnet F, Genet P, Petitddier C, Jary L, Fourcade C: CD3+CD8+CD56- clonal large granular lymphocyte leukaemia and HIV infection. Br J Haematol 1997;98:444-445.
Ghali V, Casgtella A, Louis-Charles A, Agranovsky E, Croxson ST: Expansion of large granular lymphocytes (natural killer cells) with limited antigen expression (CD2+, CD3-, CD4-, CD8-, CD16+, NKH-1) in a human immunodeficiency virus-positive homosexual man. Cancer 1990;65:2243-2247.
Moir S, Chun TW, Fauci AS. Pathogenic mechanisms of HIV disease. Annu Reve Pathol 2011;6:223-248.
Diamond C, Taylor TH, Aboumrad T, et al. Changes in acquired immunodeficiency syndrome-related non-Hodgkin lymphoma in the era of highly active antiretroviral therapy: incidence, presentation, treatment, and survival. Cancer 2006;106:128–35.
Lim ST, Karim R, Tulpule A et al. Prognostic factors in HIV-related diffuse large-cell lymphoma: before versus after highly active antiretroviral therapy. J Clin Oncol 2005;23:8477-8482. Epub 2005 Oct 17.
Arzoo KK, Bu X, Espina BM, Seneviratne L, Nathwani B, Levine AM. T-cell lymphoma in HIV-infected patients. J Acquir Immune Defic Syndr 2004;15:1020-1027.
Collins JA, Hernández AV, Hidalgo JA, Villena J, Sumire J, Delgado V, Salazar R. High proportion of T-cell systemic non-Hodgkin lymphoma in HIV-infected patients in Lima, Peru. A Acquir Immune Defic Syndr 2005;40:558-564.
Brugnoni D, Prati E, Cattaneo R, et al. The primary response to HIV infection is characterized by an expansion of activated CD8+CD28- cells. AIDS 1996;10-104-106.
Smith PR, Cavenagh JD, Milne T, Howe D, Wilkes SJ, Sinnott P, Forster GE, Helbert M: Benign monoclonal expansion of CD8+ lymphocytes in HIV infection. J Clin Pathol 2000;53:177-181.
Itescu S, Brancato LJ, Winchestger R: A sicca syndrome in HIV infection: association with HLA-DR5 and CD8 lymphocytosis. Lancet 1989;8661:466-468.
Basu D, Williams FM, Ahn CW, Reveille JD. Changing Spectrum of the Diffuse Infiltrative Lymphocytosis Syndrome. Arhtritis&Rheumatism (Arthritis Care&Research)2006;55:466-472.
Itescu S, Rose S, Dwyer E and Winchester R: Certain HLA-DR5 and –DR6 major histocompatibility complex class II alleles are associated with a CD8 lymphocytic host response to human immunodeficiency virus type 1 characterized by low lymphocyte viral strain heterogeneity and slow disease progression. Proc Natl Acad Sci USA 1994; 91;11472-76.
Ghrenassia, Etienne, Louise Roulin, Aude Aline-Fardin, Christophe Marzac, Frederic Feger, Julie Gay, Jerome Pacanowski, Alexandre Hertig, and Paul Coppo. "The Spectrum of Chronic CD8 T-Cell Expansions: Clinical Features in 14 Patients." PLoS ONE 9.3 (2014): n. pag. Web.
Viny AD, Lichtin A, Pohlman et al. Chronic B-cell dyscrasias are an important clinical feature of T-LGL leukemia. Leuk Lymphoma 2008;49:932-938.
Isenalumhe L., Van den Bergh M., Wang E., et al. Frequency of additional malignancies in patients with large granular lymphocytic leukemia (LGLL): A single Institutional experience. J Clin Oncol. 2017; 35(8 Supplement): 7542.
Van den Bergh M., Isenalumhe L., Wang E., et al. A single institution analysis of patients with dual diagnosis of T-cell large granular lymphocytic leukemia and either a plasma cell and/or a B-cell lymphoproliferative Disorder. Clin Lymphoma Myeloma Leuk. 2016; 16 (2 Supplement): 117.