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Reply to the letter from Drs Matutes and Catovsky

Leukemia volume 17, page 1683 (2003)Cite this article

TO THE EDITOR

The point of our letter in the December 2002 issue of Leukemia1 was simply to suggest that there are likely to be mature T-cell leukemias which do not represent one of the entities recognized by the recent WHO classification of lymphoid neoplasms.2 These entities include T-cell prolymphocytic leukemia (T-PLL), adult T-cell leukemia/lymphoma, mycosis fungoides/Sezary syndrome, T-cell large granular lymphocytic leukemia, and, potentially, peripheral T-cell lymphoma with a leukemic component. The existence of such problematic cases is suggested by a recent case report which contained both karyotypic information and follow-up data.3 In that report, Soma and co-workers describe a 73-year-old male with a chronic mild lymphocytosis which would be best classified as T-PLL under the WHO classification, yet which demonstrated multiple cytogenetic abnormalities without the characteristic inv(14)(q11q32) or t(14;14)(q11;q32) of T-PLL, and which showed remarkably indolent clinical behavior compared to T-PLL. While the median survival in T-PLL is less than 1 year,2 this patient was reportedly asymptomatic without therapy for over 7 years, leading the authors to speculate whether this case represented a T-CLL-like entity. Follow-up of this patient will be very useful to determine whether the acquisition of trisomy 8 in the most recent cytogenetic evaluation of this leukemia portends a more aggressive clinical behavior, as chromosome 8 abnormalities are common in T-PLL.2

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References

  1. Kussick SJ, Wood BL, Sabath DE . Mature T cell leukemias which cannot be adequately classified under the new WHO classification of lymphoid neoplasms. Leukemia 2002; 16(12): 2457–2458.

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  2. Jaffe ES, Harris NL, Stein H, Vardiman JW . Pathology and Genetics of Tumours of the Hematopoietic and Lymphoid Tissues. IARC Press, 2001, pp 195–196.

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  3. Soma L, Cornfield DB, Prager D et al. Unusually indolent T-cell prolymphocytic leukemia associated with a complex karyotype: is this T-cell chronic lymphocytic leukemia?. Am J Hematol 2002; 71(3): 224–226.

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  1. Department of Laboratory Medicine, Box 357110 University of Washington Medical Center, 1959 NE Pacific Street, Seattle, 98195, WA, USA

    S J Kussick, B L Wood & D E Sabath

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  1. S J Kussick
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  2. B L Wood
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  3. D E Sabath
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Kussick, S., Wood, B. & Sabath, D. Reply to the letter from Drs Matutes and Catovsky. Leukemia 17, 1683 (2003). https://doi.org/10.1038/sj.leu.2403002

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