Analysis of Treatment Outcome in Large Granular Lymphocytic Leukemia: A Retrospective Study from India

Abstract

Large granular lymphocytic (LGL) leukemia is a rare and indolent lymphoproliferative disorder that belongs to mature T and natural killer (NK) cell neoplasms, as per the World Health Organization classification. This article assesses the response to immunosuppressive therapy. In this retrospective study, various cases of chronic lymphoproliferative disorders (CLPDs) evaluated and treated in two tertiary care settings were screened and taken for subanalyses. After fulfilling the criteria for LGL leukemia, cases were further assessed for presenting features and response to treatment. Statistical analysis was performed using the Statistical Package for the Social Sciences, version 23. Out of 384 cases of CLPDs analyzed, 14 cases of LGL leukemia were identified (3.64%) and subjected to further analysis. There were six males (42.85%) and eight females (57.14%) (M: F = 1:1.33) with an age group ranging from 42 to 82 years. Thirteen cases (92.85%) were T-LGL type, and one case belonged to NK-LGL type (7.14%). Anemia was the most common presentation (92.85% of cases), followed by lymphocytosis (85.71% of cases) and neutropenia (78.57% of cases). Four patients (28.57%) presented with thrombocytopenia, and two patients presented with pancytopenia (14.28%). Splenomegaly was seen in two patients (14.28%), and lymphadenopathy in one patient (7.14%). One patient (7.14%) had rheumatoid arthritis, and one (7.14%) had recurrent chest infections. Out of the 14 cases, 5 (35.71%) attained complete remission, 5 (35.71%) attained partial remission, 2 patients were resistant to first-line treatment, and 2 patients were closely followed with observation only. The overall treatment response rate was 83.33%. This study highlights the excellent response rates with immunosuppressive therapy in a rare lymphoproliferative disorder.