Genotypic and phenotypic evidence of T-cell leukemia in a patient successfully treated by interferon-alpha for typical hairy cell leukemia

A 53-year-old man was diagnosed to have typical hairy cell leukemia. Immunophenotyping of frozen splenic tissue showed clonality of hairy cells for mu lambda, confirmed by the corresponding immunoglobulin gene rearrangements. The patient was successfully treated with interferon-alpha (IF-alpha). In...

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Vydáno v:Leukemia Ročník 5; číslo 12; s. 1031
Hlavní autoři: Knecht, H, Sarraj, A, Delacrétaz, F, Bachmann, E, Clément, F
Médium: Journal Article
Jazyk:angličtina
Vydáno: England 01.12.1991
Témata:
Bone Marrow - pathology
Clone Cells
DNA, Viral - analysis
Gene Rearrangement, B-Lymphocyte
Gene Rearrangement, T-Lymphocyte
Genes, Immunoglobulin
Herpesvirus 4, Human - genetics
Humans
Interferon-alpha - therapeutic use
Leukemia, Hairy Cell - pathology
Leukemia, Hairy Cell - therapy
Leukemia, T-Cell - etiology
Middle Aged
Neoplasms, Second Primary - etiology
Neoplasms, Second Primary - pathology
Receptors, Antigen, T-Cell, alpha-beta - genetics
Recombinant Proteins
ISSN:0887-6924
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Shrnutí:A 53-year-old man was diagnosed to have typical hairy cell leukemia. Immunophenotyping of frozen splenic tissue showed clonality of hairy cells for mu lambda, confirmed by the corresponding immunoglobulin gene rearrangements. The patient was successfully treated with interferon-alpha (IF-alpha). In the fifth year of treatment with IF-alpha the morphology of peripheral blood mononuclear cells (PBMC) and of bone marrow infiltration changed with the appearance of numerous small to intermediate shaped lymphocytes of a T-helper phenotype. Frank leukemia, resistant to IF-alpha treatment and ultimately aggressive chemotherapy, developed. Emergence of this second clonal disease was confirmed by rearrangement studies performed on PBMC; rearrangements of both alleles of the TCR beta were identified, whereas the JH and lambda IVS genes were in germline configuration. The outgrowth of a second, malignant T-cell clone paralleled by the disappearance (down-regulation?) of the initial B-cell clone while under cytokine treatment is consistent with the possibility that IF-alpha favoured the emergence of this second clone.
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ISSN:0887-6924