Large granular lymphocytic (LGL) leukemia is an uncommon disease, characterized by a clonal proliferation of mature, post-thymic T-cells, typically CD3+, CD4-, CD8+, CD16+, CD57+ phenotype, representing constitutively active T-cells Less commonly, LGL leukemia is derived from CD3-, CD56+ natural killer (NK) cells. Clonal T-LGLs escape apoptosis by failure to respond to the Fas/Fas ligand (FasL) pathway. Activating mutations in the STAT3gene occur frequently in LGL leukemia, and may play a role in pathogenesis. Autoimmune disorders are frequently associated with LGL leukemia (~1/3 present with rheumatoid arthritis).
The association between LGL leukemia and B-cell lymphoproliferative disorders has been reported, often with low-grade histologies, but is deemed uncommon and the pathogenesis is not well established. We have analyzed a series of patients (pts) diagnosed with both LGL leukemia or expansion and clonal B-cell disorders.
Patients and methods:
Pts with NK or T-LGL leukemia or expansion who were evaluated at Fox Chase Cancer Center or the Cleveland Clinic Taussig Cancer Institute were reviewed, after Institutional Review Board approval. Inclusion criteria were age ≥ 18 yrs and diagnosis of both LGL and B-cell lymphoproliferative disorder.
Results:
One hundred and twenty six pts with a diagnosis of T-LGL leukemia, NK-LGL leukemia or T-LGL expansion were identified. Of these, 44 (34.9%) pts were diagnosed with a clonal B-cell disorder. Twenty-six pts (20.6%) were diagnosed with a clonal B-cell disorder concomitantly with or shortly after the LGL diagnosis, 15 of whom presented with monoclonal gammopathy of unknown significance (MGUS) as their B-cell disorder, 9 with monoclonal B-cell lymphocytosis (MBL), 5 of whom also had monoclonal gammopathy . Eighteen pts (14.2%) had a previous diagnosis of clonal B-cell disorder, including diffuse large B cell lymphoma (DLBCL) (N= 6), CLL (N = 3), mantle cell lymphoma (N=3), multiple myeloma (N = 2), Hodgkin lymphoma (N = 2), Burkitt lymphoma (N = 1) and hairy cell leukemia (N = 1 ). Fifteen pts (11.9%) received treatment prior to the diagnosis of LGL, 10 of them (7.9%) with regimens including rituximab. The median time from completion of last treatment with rituximab to diagnosis of LGL disorder was 33 months. An additional patient with prior DLBCL was diagnosed with LGL shortly after receiving an oral SYK inhibitor.
Two illustrative patients had unexpectedly prolonged remissions of their B cell disorder. A 66 years old man with multiple myeloma who achieved complete remission (CR) after 8 months of bortezomib therapy was then diagnosed with T-LGL, and his myeloma is in ongoing remission now 5 years after T-LGL diagnosis without further therapy.
Lymphoid tissue is made up of cells called lymphocytes, a type of white blood cell that fights infection. There are 2 major types of lymphocytes: B lymphocytes (B cells) and T lymphocytes (T cells). Normal T cells and B cells have different jobs. But because all the importance of these cells they can travel around the body spreading the cancerous cells. There are four stages for Hodgkin’s lymphoma when testing is completed the doctors can determine what stage the cancer is at and what treatment will be best suited to fighting the disease.
Hodgkin 's Lymphoma occurs when following a mutation in the lymphocyte DNA. The mutation occurs after birth, meaning that Hodgkin’s disease is not hereditary. The mutated DNA can lead to the uncontrolled growth of cancerous lymphocytes if untreated. The cancerous lymphocytes produce tumor masses in the lymph
On Sunday, a nurse on a medical/surgical floor in a large private hospital is assigned as the primary nurse to a woman who was just admitted. The woman’s testing begins on Monday and the primary nurse does not have work for the next few days. The nurse returns on Saturday and goes over the woman’s charts. The nurse discovers that the woman has chronic lymphocytic leukemia and is being treated for the disease. After approaching the woman the nurse realizes that the woman is unaware of her diagnoses as she asks the nurse when she will be able to return to work. The nurse explains that she has not yet spoken with the physician and will get back to her once she has done so. On your way back to the nurses' station, one of the woman's two daughters approaches the nurse and urges the nurse to assure her mother that there is no reason for concern. The daughter explains that her mother has just been through a painful divorce and
...se them to become resistant to Gleevec. These mutations change the shape of bcr-abl to some extent that the treatment will not work on them, such that Gleevec can no longer bind to bcr-abl and activate it; which leads to gleevec resistance within patients with CML. Yet, using another Kinase inhibitor as an alternative to Gleevec which would block the mutated version of bcr-abl that causes resistance with Gleevec could be used to treat the new mutated version of bcr-abl. Such as: dasatinib, nilotinib, bosutinib, or ponatinib. Subsequently, even if the bcr-abl gene is not found in the patients blood, that still doesn't guarantee they are cured for now, so they are recommended to stay on the drug indefinitely. If all fails then patients are told to consider stem cell transplant as a last resort, especially for younger people who have a donor with a matching tissue type.
..., MIKOŁUĆ, B., PIETRUCHA, B., & WOLSKA-KUŚNIERZ, B. (2013). Clinical and immunological analysis of patients with X-linked agammaglobulinemia: single center experience. Central European Journal of Immunology, 38(3), 367-370.
The World Health Organization (WHO) classifies Hodgkin’s lymphoma into two different groups: nodular lymphocyte predominant (NLPHL) and classical HL (cHL). NLPHL develops slowly, is found predominantly in males, and accounts for about 5% of all HL cases. It is characterized by L&H cells and a different antigenic profile (Roddle, Peggs, 2009, p. 208). In contrast, cHL, the most common subtype, comprises nearly 80% of diagnosed cases. Classical HL is divided into four subtypes. “The diagnosis is dependent on the pathological finding of H...
The patient presented in this paper is Ms. H an 83 year old African American woman that appears younger than stated age with a history of Multiple Myeloma. The patient chart was reviewed and an interview conducted. Interestingly the patient had retained every note, lab, hospital H&P and discharge summary in a file folder in her possession. Ms. H was diagnosed with Multiple Myeloma in April of 2008 when she was being worked up at her dentist for a toothache. X-rays performed revealed she had bone lesions in her zygomatic process and in her skull above her right eye. She was referred to Oncology Hematology Care for further work-up. A bone marrow biopsy revealed she had Multiple Myeloma. During the course of treatment the patient received Thalidomide, Revlimid, Velcade, Aredia, Zometa, and Decadron. Remission was achieved and the patient underwent stem cell transplant in February of 2009. The transplant was successful and the patient was cancer free until August of 2012 when she received news that her cancer had recurred.
Leukemia and Lymphoma Society (LLS) is the worlds largest non-profit organization which funds blood cancer research and providing patient services and education. The LLS mission is to cure leukemia, lymphoma, Hodgkin's lymphoma and myeloma and to improve quality of patients and there families. This is done by discovering new cures and making blood cancers a story of the past.The organizations national office is located in White Plains, NY. Leukemia and Lymphoma Society has local chapters through out the United States and Canada.
There are four main different types of leukemia. It is grouped by how fast it spreads and what kind of white blood cell it affects. The group of how fast leukemia spreads is either acute or chronic. Acute leukemia gets worse faster and may make a person feel sick right away. Where chronic leukemia gets worse slowly and may not cause symptoms for years. The group of what kind of blood cells leukemia affects is either lymphatic or myelogenous. Lymphatic leukemia affects white blood cells called lymphocytes. Where myelogenous leukemia affects white blood cells called myelocytes. When the two groups come together they form four main types of leukemia. They are acute lymphoblastic leukemia (ALL), acute myelogenous leukemia (AML), chronic lymphoblastic leukemia (CLL), and chronic myelogenous leukemia (CML). Each type is different in its own way but experts still don’t know for sure what causes leukemia.
“The word 'leukemia' is a very frightening word. In many instances, it's a killer and it's something that you have to deal with in a very serious and determined way if you're going to beat it” - Kareem Abdul-Jabbar. Many people, including tons of children, fight leukemia every day trying to beat this vicious cancer. Without knowing how leukemia is exactly caused, it puts a damper on how to avoid it.
- Chronic lymphocytic leukemia (CLL): is a type of blood cancer that begins in the bone marrow. Depending on the patients and progress of the cancer, it will either grow...
What is Leukemia? Leukemia is a cancer in blood forming cells that are in early stages of development. Most of the time the white blood cells, but some types of leukemia start in other types of blood cells. Blood cells are form in bone marrow. Any of these cells can turn into a leukemia cell, once this happens the cell does not mature like it should. The cell may start to produce rapidly and the mutated cells probably won’t go through apoptosis like they should. These cells build up in the bone marrow and crowd out the healthy cells. Typically, leukemia cells get into the blood stream rather quickly. From the blood stream they can spread to places like lymph nodes, spleen, liver, central nervous system or other organs where the leukemia cells can cause those other cells to function irregularly.
Light chain myeloma is the production of incomplete immunoglobins. Light chain myeloma causes only a portion of the immunoglobin protein (the light chain) to be produced, rendering these immunoglobins incapable of fighting infection. Light chain myeloma accounts for 20 percent of all multiple myeloma diagnosis.
Kanwar, V.S. (2013, Sep 16). Diseases & Conditions - Medscape Reference. Pediatric Acute Lymphoblastic Leukemia. Retrieved January 13, 2014, from http://emedicine.medscape.com/article/990113-overview#a0156
Hodgkin's and Non-Hodgkin's Lymphoma: Differences? and similarity on MedicineNet.com. Retrieved December 9, 2013, from http://www.cdl.gov http://www.medicinenet.com/script/main/art.asp?articlekey=79261 Turley, Susan M. (2014). The 'Path of Medical language (third ed.). Upper Saddle River, NJ: Pearson. Education & Training, Inc. Zimmerman, K. A. & Co.,