True T-cell chronic lymphocytic leukemia

A morphologic and immunophenotypic study of 25 cases

James Hoyer, C. W. Ross, C. Y. Li, Thomas Elmer Witzig, R. D. Gascoyne, G. W. Dewald, C. A. Hanson

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Abstract

We studied 25 T-cell chronic lymphocytic leukemia (T-CLL) cases collected over a 15-year period. Immunophenotypic analysis was performed in each case; 12 cases were evaluated by cytogenetics, and gene rearrangement studies were performed in 14 cases. The median age was 57 years with a mate predominance (M:F, 15:10). The median presenting lymphocyte count was 36.3 x 103/L (range, 3.9 to 438 x 103/L). Fourteen patients (56%) had shotty adenopathy and ten (40%) had mild-to-moderate splenomegaly at presentation; four (16%) had erythematous skin lesions. The lymphocytes were predominantly small; some cases had a minor component of medium-sized cells (<10%). The nuclear:cytoplasmic ratios were uniformly high with round to oval nuclei; however, a wide spectrum of nuclear outlines could be found, ranging from minimally to markedly convoluted. Nucleoli were either absent or small and inconspicuous. These lymphocytes did not have the morphology of prolymphocytes and did not contain cytoplasmic granules. Bone marrow infiltration was generally in an interstitial pattern; the degree of involvement ranged from 15% to 90%. Immunophenotyping showed that the lymphocytes were mature T-cells with a predominant CD4+ immunophenotype. Three cases displayed a CD8+ immunophenotype. The patients were treated with a variety of chemotherapeutic regimens with only a minimal response observed in two of 20 patients. We conclude that T-CLL is an uncommon chronic lymphoproliferative disorder (CLPD) that can be morphologically similar to B- CLL, is distinct from T-prolymphocytic leukemia, and has an aggressive clinical course that is refractory to therapy. It may also be difficult to distinguish T-CLL from other T-CLPD, especially the leukemic phase of peripheral T-cell lymphoma and some cases of Sezary syndrome.

Original languageEnglish (US)
Pages (from-to)1163-1169
Number of pages7
JournalBlood
Volume86
Issue number3
StatePublished - 1995

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T-Cell Prolymphocytic Leukemia
T-cells
Lymphocytes
Lymphoproliferative Disorders
Prolymphocytic Leukemia
Sezary Syndrome
Peripheral T-Cell Lymphoma
Cytoplasmic Granules
T-Lymphocytes
Immunophenotyping
Gene Rearrangement
Splenomegaly
Lymphocyte Count
Cytogenetics
Bone Marrow
Skin
Infiltration
Refractory materials
Bone
Genes

ASJC Scopus subject areas

  • Hematology

Cite this

Hoyer, J., Ross, C. W., Li, C. Y., Witzig, T. E., Gascoyne, R. D., Dewald, G. W., & Hanson, C. A. (1995). True T-cell chronic lymphocytic leukemia: A morphologic and immunophenotypic study of 25 cases. Blood, 86(3), 1163-1169.

True T-cell chronic lymphocytic leukemia : A morphologic and immunophenotypic study of 25 cases. / Hoyer, James; Ross, C. W.; Li, C. Y.; Witzig, Thomas Elmer; Gascoyne, R. D.; Dewald, G. W.; Hanson, C. A.

In: Blood, Vol. 86, No. 3, 1995, p. 1163-1169.

Research output: Contribution to journalArticle

Hoyer, J, Ross, CW, Li, CY, Witzig, TE, Gascoyne, RD, Dewald, GW & Hanson, CA 1995, 'True T-cell chronic lymphocytic leukemia: A morphologic and immunophenotypic study of 25 cases', Blood, vol. 86, no. 3, pp. 1163-1169.
Hoyer, James ; Ross, C. W. ; Li, C. Y. ; Witzig, Thomas Elmer ; Gascoyne, R. D. ; Dewald, G. W. ; Hanson, C. A. / True T-cell chronic lymphocytic leukemia : A morphologic and immunophenotypic study of 25 cases. In: Blood. 1995 ; Vol. 86, No. 3. pp. 1163-1169.
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