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T-cell large granular lymphocyte (T-LGL) leukemia is a rare leukemia originating from CD3+, CD4−, and CD8+ T cells.1 It is an indolent disease often associated with autoimmune manifestations, including rheumatoid arthritis, neutropenia, and pure red cell aplasia (PRCA).2 Two unusual cases of T-LGL leukemia presented with prominent peripheral neuropathy, which improved significantly with successful leukemia treatment.
Case reports.
Patient 1 was a 56-year-old man who sought treatment in 1996 for finger numbness, reduced dexterity, a severe glove and stocking sensory neuropathy extending to the elbow and knee, absent knee and ankle reflexes, but no motor weakness or ataxia. A blood count showed hemoglobin (Hb) 10.3 g/dL, white cell count (WCC) 3.5 × 109/L (60% of LGL), and platelet count (Plat) 210 × 109/L. The marrow was infiltrated by CD3+, CD4−, CD8+, and CD56− T cells with clonal T-cell receptor-γ (TCRγ) gene rearrangement, confirming the diagnosis of T-LGL leukemia. …
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