SEVERE NEUTROPENIA IN T-LARGE GRANULAR LYMPHOCYTE LEUKEMIA CORRECTED BY INTENSIVE IMMUNOSUPPRESSION

Optimum treatment of severe neutropenia, a major factor for morbidity and mortality in T-large granular lymphocyte (LGL) leukemia, is undefi ned. We observed a rapid improvement of the neutrophil count in a pati ent with T-LGL leukemia and severe neutropenia after the combined admi nistration of antilymphocyte-globulin (ALG), cyclosporin A, prednisone , and granulocyte colony-stimulating factor (G-CSF). Although G-CSF tr eatment was terminated after 7 days, the neutrophil count has persiste d above 1.0 x 10(9)/1 for up to 6 months now. Oral methotrexate is giv en continuously as treatment for T-LGL leukemia. The response to this immunosuppressive regimen suggests a T-cell-mediated mechanism as the underlying cause for neutropenia in T-LGL leukemia.