Coexistence of T-Large Granular Lymphocyte Leukemia and Peripheral T Cell Lymphoma-NOS with indolent behaviour
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Keywords
PTCL-NOS, LGLL, Aggressive T-cell lymphomas, Indolent T-cell lymphomas
Abstract
T-cell lymphomas and leukemias are highly heterogeneous groups of rare disorders. We report a case of a 68-year-old man patient who develops two different T-cell neoplasms (Large Granular Lymphocyte Leukemia [LGLL] in 2018 and Peripheral T-cell non-Hodgkin lymphoma not otherwise specified [PTCL-NOS] in 2019) with a previous diagnosis of B-cell marginal zone lymphoma in 2010, treated with two lines of chemo-immunotherapy. The coexistence of these different T-cell neoplasms is rarely reported in literature and, moreover, is usually described as an LGLL transformation into PTCL-NOS; differently from these examples, herein the simultaneous conditions appear to be driven by different T-cell clones. Furthermore, the PTCL-NOS had a quite unusual behaviour, with a good disease control without intensive treatment. Because of these features, it could belong to a subgroup of indolent PTCL-NOS, not yet described in the WHO classification of T-cell neoplasms, which could benefit of less aggressive treatment.
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References
[2] Pizzi M, Margolskee E, Inghirami G. Pathogenesis of Peripheral T Cell Lymphoma. Annual Review of Pathology: Mechanisms of Disease 2018. https://doi.org/10.1146/annurev-pathol-020117-043821.
[3] Lamy T, Moignet A, Loughran TP. LGL leukemia: From pathogenesis to treatment. Blood 2017. https://doi.org/10.1182/blood-2016-08-692590.
[4] Barilà G, Calabretto G, Teramo A, Vicenzetto C, Gasparini VR, Semenzato G, et al. T cell large granular lymphocyte leukemia and chronic NK lymphocytosis. Best Practice and Research: Clinical Haematology 2019. https://doi.org/10.1016/j.beha.2019.06.006.
[5] Teramo A, Barilà G, Calabretto G, Ercolin C, Lamy T, Moignet A, et al. STAT3 mutation impacts biological and clinical features of T-LGL leukemia. Oncotarget 2017. https://doi.org/10.18632/oncotarget.18711.
[6] Broccoli A, Zinzani PL. Peripheral T-cell lymphoma, not otherwise specified. Blood 2017. https://doi.org/10.1182/blood-2016-08-692566.
[7] Swerdlow SH, Campo E, Pileri SA, Lee Harris N, Stein H, Siebert R, et al. The 2016 revision of the World Health Organization classification of lymphoid neoplasms. Blood 2016. https://doi.org/10.1182/blood-2016-01-643569.
[8] d’Amore F, Gaulard P, Trümper L, Corradini P, Kim WS, Specht L, et al. Peripheral T-cell lymphomas: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Annals of Oncology 2015. https://doi.org/10.1093/annonc/mdv201.
[9] Lee J, Park K, Kim KH, Bang HI, Yoon SY, Choi IH. Diagnostic challenges of indolent peripheral T cell lymphoma: A case report and literature review. Medicine 2020. https://doi.org/10.1097/MD.0000000000022657.
[10] Penn I. The role of immunosuppression in lymphoma formation. Springer Seminars in Immunopathology 1998. https://doi.org/10.1007/s002810050040.
[11] Nijland ML, Koens L, Pals ST, Ten Berge IJM, Bemelman FJ, Kersten MJ. Clinicopathological characteristics of T-cell non-Hodgkin lymphoma arising in patients with immunodeficiencies: A single-center case series of 25 patients and a review of the literature. Haematologica 2018. https://doi.org/10.3324/haematol.2017.169987.
[12] Savola P, Rajala H, Mustjoki S. LGL leukemia and autoimmunity - the borderline between autoimmune disease and cancer is becoming blurred. Duodecim; Laaketieteellinen Aikakauskirja 2016.
[13] Yoshida N, Nishikori M, Izumi T, Imaizumi Y, Sawayama Y, Niino D, et al. Primary peripheral T-cell lymphoma, not otherwise specified of the thyroid with autoimmune thyroiditis. British Journal of Haematology 2013. https://doi.org/10.1111/bjh.12255.
[14] Perry AM, Warnke RA, Hu Q, Gaulard P, Copie-Bergman C, Alkan S, et al. Indolent T-cell lymphoproliferative disease of the gastrointestinal tract. Blood 2013. https://doi.org/10.1182/blood-2013-07-512830.
[15] Matutes E, Wotherspoon AC, Parker NE, Osuji N, Isaacson PG, Catovsky D. Transformation of T-cell large granular lymphocyte leukaemia into a high-grade large T-cell lymphoma. British Journal of Haematology 2001. https://doi.org/10.1046/j.1365-2141.2001.03220.x.
[16] Belhadj M, Mansour D, Kaltenbach S, Deau-Fischer B, Franchi P, Tamburini J, et al. T-cell large granular lymphocyte leukemia transfomation into aggressive t-cell lymphoma: A report of two cases with molecular characterization. Haematologica 2019. https://doi.org/10.3324/haematol.2018.205542.
[17] Nakmaura N, Carreras J, Kikuti YY, Miyaoka M, Tomita S, Ishida F. RICHTER TRANSFORMATION OF T-CELL LARGE GRANULAR CELL LEUKEMIA. Hematological Oncology 2017. https://doi.org/10.1002/hon.2439_164.
[18] Hayashi E, Takata K, Sato Y, Tashiro Y, Tachiyama Y, Sawada-Kitamura S, et al. Distinct morphologic, phenotypic, and clinical-course characteristics of indolent peripheral T-cell lymphoma. Human Pathology 2013. https://doi.org/10.1016/j.humpath.2013.03.002.