Hairy cell leukemia and variant in Taiwan: report of a variant case and literature review

International Journal of Clinical and Experimental Pathology

Ching-Nan Lin¹  Shen-Tsung Chang¹  Shih-Sung Chuang¹  Chin-Yang Li¹  Chao-Jung Tsao¹  Yen-Chuan Hsieh¹  Chin-Li Lu¹ 

关键词: CDllc;    CD25;    CD103;    hairy cell leukemia;    hairy cell leukemia variant;    Taiwan;   

DOI  :  

学科分类：生理学与病理学

来源: e-Century Publishing Corporation

【 摘 要 】

Hairy cell leukemia (HCL) is characterized by leukemic cells with abundant “hairy” cytoplasm, strong cytoplasmic positivity for tartrate-resistant acid phosphatase (TRAP), characteristic immunophenotype and sensitivity to treatment with purine nucleoside analogs. HCL-variant (HCL-v) encompasses chronic B-cell leukemias resembling classical HCL but exhibiting variant cytomorphology, variant immunophenotype and resistance to conventional HCL therapy. We present the case of a 67-year-old Taiwanese male with HCL-v who had leukocytosis and splenomegaly. His hairy leukemic cells were weakly positive for TRAP and expressed CDllc and CD103 but not CD25. He received oral chemotherapy with chlorambucil and in complete hematological remission in 9 months but relapsed 2 months later. Literature review revealed 9 cases of HCL and 3 cases of HCL-v including current case from Taiwan. All patients were adults with splenomegaly. The HCL patients had a significantly higher frequency of leukopenia (p = 0.024) and monocytopenia (p = 0.008) and a lower frequency of leukocytosis (p = 0.018) than HCL-v patients. All 8 HCL patients responded favorably to 2-chlorodeoxyadenosine with or without splenectomy. The 3 HCL-v patients had leukocytosis and received chemotherapy with variable outcome. HCL and HCL-v are rare in Taiwan and their pathological and immunophenotypical features were not fully characterized. A multimodality approach incorporating hematological findings, cytomorphology, histopathology, cytochemistry, complete immunophenotypingand clinical features is needed to identify and characterize such cases in Taiwan.

【 授权许可】

Unknown