To Investigate The Clinical Features Of T Large Granular Lymphocytic Leukemia And Its Effect On The Time To Initial Remission

Objective:T large granular lymphocytic leukemia(T-LGLL)is a rare disease in the blood system.This paper summarized the clinical features,immunophenotype and T cell receptor(TCR)rearrangement of 87 patients with T-LGLL.To reveal the clinical features affecting the time to initial remission,and the relationship between clinical features with the treatment effect aiming to provide new ideas for the diagnosis of T-LGLL and prediction of curative effect.Methods:To summarize the clinical features of T-LGLL,we collected the clinical data of87 patients with T-LGLL,of which 10 were from T-LGLL patients diagnosed and treated in our hospital from January 2011 to December 2021,and 77 were obtained from database retrieval of published case reports during the same period.At the same time,we used univariate COX regression analysis to screen the clinical characteristics that may affect the time of initial remission in T-LGLL patients,and then used the Log-rank test to verify its effect on the initial remission time.Finally we established a multivariate COX regression model to analyze independent influencing factors.Result:A total of 87 T-LGLL patients were included in this group,including 41 males and 46 females,with a median age of 58 years.Of these,70 patients presented with anemia,62 with neutropenia,and 21 with thrombocytopenia.30 patients complicated with pure red cell aplastic anemia.Immunophenotype of 52 patients was CD3~+CD4~-CD8~+TCRαβ~+.TCR rearrangement detection was performed in 66 patients,and20 patients showed positive TCRγrearrangement.Flow cytometry analysis of V-βgene lineage was performed in 21 patients,including 6 cases of Vβ1 clone fragment.Univariate COX regression and Log-rank test were used to analyze the influence of clinical characteristics on the time to initial remission.The results showed that age greater than 60 years old,moderate to severe anemia,thrombocytopenia and combined pure red cell aplastic anemia were the main factors affecting the time to initial remission in this group of patients.And the multivariate COX regression model analysis showed that age greater than 60 years and thrombocytopenia were independ-ent adverse characteristics affecting the time to initial remission.Conclusion:T-LGLL mostly occurs in the middle-aged and elderly population,with no difference in the ratio of males and females,and mostly manifests as anemia and neutropenia;it is often complicated by pure red cell aplastic anemia.The most common immunophenotype of T-LGLL is CD3~+CD4~-CD8~+TCRαβ~+;TCR rearrange-ment is mostlyγmonoclonal rearrangement.In addition,age greater than 60 years and thrombocytopenia are independent adverse features affecting the time of initial remission in patients with T-LGLL.