Abstract
T-cell large granular lymphocytic (T-LGL) leukemia is a rare clonal proliferation presenting with cytopenia, splenomegaly, and autoimmune manifestations. It has rarely been described in recipients of solid organ transplants.We report the clinical case of a young kidney transplant recipient that developed T-LGL leukemia 3 years after kidney transplantation. The disorder manifested with a severe form of autoimmune hemolytic anemia in the absence of other laboratory abnormalities. The anemia was successfully treated with an intense course of corticosteroids ands witch of immunosuppressive therapy from a calcineurin inhibitor to sirolimus, a mammalian target of rapamycin inhibitor.Our case shows that autoimmune hemolytic anemia can be a life-threatening manifestation of T-LGL disease. The antiproliferative effects of sirolimus may be useful in the treatment of symptoms of T-LGL leukemia in kidney transplantation.
Highlights
T-cell large granular lymphocytic (T-LGL) leukemia is a rare clonal proliferation presenting with cytopenia, splenomegaly, and autoimmune manifestations
We presented to the best of our knowledge the first case of hemolytic autoimmune anemia resulting from T-LGL leukemia in a recipient of kidney transplant (KT)
T-LGL leukemia is considered to be an indolent disorder by the hematologic community and is treated with immunosuppressive therapy
Summary
T-cell large granular lymphocytic (T-LGL) leukemia is a rare clonal proliferation presenting with cytopenia, splenomegaly, and autoimmune manifestations. At the age of 19 years, after 1 year of hemodialysis, a second kidney transplant from a cadaveric donor was performed. The post-transplantation course was uneventful, and the patient was discharged with normal renal function. A diagnosis of asymptomatic T-LGL leukemia was performed after the detection of relative lymphocytosis noted on the complete blood count.
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