Allogeneic hematopoietic stem cell transplantation treatment for chronic lymphoproliferative disorder of natural killer cells combined with acute myeloid leukemia: a case report
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摘要: 慢性NK细胞淋巴增殖性疾病(CLPD-NK)是一种罕见的成熟自然杀伤(NK)细胞淋巴增殖性疾病。本文报道1例CLPD-NK合并急性髓系白血病(AML)的病例,临床上极为罕见。本例患者长期白细胞减少,经过骨髓检查及NK细胞克隆性筛查确诊CLPD-NK,予以激素联合免疫抑制剂治疗。后患者骨髓检查提示原始细胞增多,流式提示髓系表达,考虑CLPD-NK合并AML,经过化疗及异基因造血干细胞移植后,无病生存至今。
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关键词:
- 慢性NK细胞淋巴增殖性疾病 /
- 急性髓系白血病 /
- 异基因造血干细胞移植
Abstract: Chronic lymphoproliferative disorder of natural killer cells (CLPD-NK) is a rare mature natural killer (NK) cell lymphoproliferative disorder. This article reports a case of CLPD-NK combined with acute myeloid leukemia (AML), which is extremely rare in clinical practice. The patient had a long history of leukopenia and was diagnosed with CLPD-NK through bone marrow examination and NK cell clonality screening. Treatment with glucocorticoids combined with immunosuppressants was applied. Subsequently, bone marrow examination revealed an increase in blats and flow cytometry suggested myeloid expression, leading to the consideration of CLPD-NK combined with AML. After chemotherapy and allogeneic hematopoietic stem cell transplantation, the patient has remained disease-free to this day. -
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[1] Magnano L, Rivero A, Matutes E. Large Granular Lymphocytic Leukemia: Current State of Diagnosis, Pathogenesis and Treatment[J]. Curr Oncol Rep, 2022, 24(5): 633-644. doi: 10.1007/s11912-021-01159-y
[2] Swerdlow SH, Campo E, Pileri SA, et al. The 2016 revision of the World Health Organization classification of lymphoid neoplasms[J]. Blood, 2016, 127(20): 2375-2390. doi: 10.1182/blood-2016-01-643569
[3] Moignet A, Lamy T. Latest Advances in the Diagnosis and Treatment of Large Granular Lymphocytic Leukemia[J]. Am Soc Clin Oncol Educ Book, 2018, 38: 616-625.
[4] An H, Guo J, Guo H, et al. Peripheral neuropathy associated with chronic lymphoproliferative disorders of natural killer cells(CLPD-NK): a case report and literature review[J]. BMC Neurol, 2023, 23(1): 314. doi: 10.1186/s12883-023-03310-7
[5] Matutes E. Large granular lymphocytic leukemia. Current diagnostic and therapeutic approaches and novel treatment options[J]. Expert Rev Hematol, 2017, 10(3): 251-258. doi: 10.1080/17474086.2017.1284585
[6] Barilà G, Teramo A, Calabretto G, et al. Dominant cytotoxic NK cell subset within CLPD-NK patients identifies a more aggressive NK cell proliferation[J]. Blood Cancer J, 2018, 8(6): 51. doi: 10.1038/s41408-018-0088-1
[7] Bárcena P, Jara-Acevedo M, Tabernero MD, et al. Phenotypic profile of expanded NK cells in chronic lymphoproliferative disorders: a surrogate marker for NK-cell clonality[J]. Oncotarget, 2015, 6(40): 42938-42951. doi: 10.18632/oncotarget.5480
[8] Pastoret C, Desmots F, Drillet G, et al. Linking the KIR phenotype with STAT3 and TET2 mutations to identify chronic lymphoproliferative disorders of NK cells[J]. Blood, 2021, 137(23): 3237-3250. doi: 10.1182/blood.2020006721
[9] Herling M, Braun T. Tracing the roots of CLPD-NK by TET2 and STAT3[J]. Blood, 2021, 137(23): 3156-3158. doi: 10.1182/blood.2020010542
[10] Jerez A, Clemente MJ, Makishima H, et al. STAT3 mutations indicate the presence of subclinical T-cell clones in a subset of aplastic anemia and myelodysplastic syndrome patients[J]. Blood, 2013, 122(14): 2453-2459. doi: 10.1182/blood-2013-04-494930
[11] Sheikh S, Jahangir S, Khan S, et al. Chronic Lymphoproliferative Disorder of Natural Killer Cells: A Rare Event[J]. Cureus, 2020, 12(9): e10353.
[12] Barilà G, Calabretto G, Teramo A, et al. T cell large granular lymphocyte leukemia and chronic NK lymphocytosis[J]. Best Pract Res Clin Haematol, 2019, 32(3): 207-216. doi: 10.1016/j.beha.2019.06.006
[13] Kawakami T, Sekiguchi N, Kobayashi J, et al. STAT3 mutations in natural killer cells are associated with cytopenia in patients with chronic lymphoproliferative disorder of natural killer cells[J]. Int J Hematol, 2019, 109(5): 563-571. doi: 10.1007/s12185-019-02625-x
[14] Gasparini VR, Binatti A, Coppe A, et al. A high definition picture of somatic mutations in chronic lymphoproliferative disorder of natural killer cells[J]. Blood Cancer J, 2020, 10(4): 42. doi: 10.1038/s41408-020-0309-2
[15] Zhang R, Shah MV, Loughran TP Jr. The root of many evils: indolent large granular lymphocyte leukaemia and associated disorders[J]. Hematol Oncol, 2010, 28(3): 105-117. doi: 10.1002/hon.917
[16] Lamy T, Moignet A, Loughran TP Jr. LGL leukemia: from pathogenesis to treatment[J]. Blood, 2017, 129(9): 1082-1094. doi: 10.1182/blood-2016-08-692590
[17] Lamy T, Loughran TP Jr. How I treat LGL leukemia[J]. Blood, 2011, 117(10): 2764-2774. doi: 10.1182/blood-2010-07-296962
[18] Zaja F, Baldini L, Ferreri AJ, et al. Bendamustine salvage therapy for T cell neoplasms[J]. Ann Hematol, 2013, 92(9): 1249-1254. doi: 10.1007/s00277-013-1746-9
[19] Fleischmann R, Kremer J, Cush J, et al. Placebo-controlled trial of tofacitinib monotherapy in rheumatoid arthritis[J]. N Engl J Med, 2012, 367(6): 495-507. doi: 10.1056/NEJMoa1109071
[20] Poullot E, Zambello R, Leblanc F, et al. Chronic natural killer lymphoproliferative disorders: characteristics of an international cohort of 70 patients[J]. Ann Oncol, 2014, 25(10): 2030-2035. doi: 10.1093/annonc/mdu369
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