Large granular lymphocytic leukemia

Large granular lymphocytic leukemia
Updated: 08/30/2024
© Jun Wang, MD, PhD

General features
Clinical presentations
  • Associated with autoimmune disorders, most common rheumatoid arthritis
Key Laboratory findings
  • Lymphocytosis
  • Often severe neutropenia with or without anemia
  • Aplastic anemia, thrombocytopenia, splenomegaly, etc
Key morphological features
  • Large lymphocytes with azurophilic granules
  • Either T cell or NK cell
Genetic abnormalities
  • Activating mutation of STAT3
Diagnosis
  • Persistent (more than 6 months) increase of peripheral blood large granular lymphocytes, usually 2-20 x 10⁹
  • T cell with coexpression of NK cell associated antigens (CD16, CD56 or CD57) and decreased CD2, CD5 or CD7 expression
  • Proof of T cell clonality by molecular or flow cytometry study
  • STAT3 or STAT5b mutation



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