Treatment for CD57-negative γδ T-cell large granular lymphocytic leukemia with pure red cell aplasia: A case report

BACKGROUND T-cell large granular lymphocytic leukemia (T-LGLL) is a rare type of aplastic anemia with diverse clinical manifestations. Concomitant diseases are often present at the first manifestation. We describe the treatment of a patient with CD57-negative gamma delta T-LGLL with pure red cell aplasia (PRCA). CASE SUMMARY A 34-year-old woman with a 20-year history of anemia visited our hospital owing to severe dizziness and was admitted. Her condition was diagnosed as CD57negative gamma delta T- LGLL with PRCA through bone marrow cytology, bone marrow pathology, bone marrow flow cytometry, bone marrow multiplex polymerase chain reaction combined with fluorescent fragment analysis, and other tests. Treatment with prednisone, methotrexate, and subcutaneous erythropoietin did not significantly change her hemoglobin level. After treatment with oral cyclophosphamide for 3 mo, her hemoglobin level increased to approximately 100 g/L. After 5 mo of treatment, the patient could perform activities of daily living independently. CONCLUSION The treatment of CD57- negative gamma delta T-LGLL with PRCA with cyclophosphamide helps to improve prognosis.

Automated summary

T-cell large granular lymphocytic leukemia (T-LGLL) is a rare type of aplastic anemia with diverse clinical manifestations, often presenting with concomitant diseases. In this case study, a 34-year-old woman with a 20-year history of anemia was diagnosed with CD57-negative gamma delta T-LGLL with pure red cell aplasia (PRCA). Treatment with cyclophosphamide helped to improve the patient's prognosis, with increased hemoglobin levels and improved ability to perform daily living activities after 5 months of treatment.