Large granular lymphocytic leukemia
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LGL with treatment indications
Cyclophosphamide (Cytoxan)
Regimen
Retrospective
These are retrospective series. The most common dose reported is 100 mg PO once per day; some authors mentions co-administration of steroids but details are not supplied.
- Cyclophosphamide (Cytoxan) 50 to 100 mg PO once per day
Lamy et al. 2011 recommends that patients who are responding are continued on treatment for 6 to 12 months; patients who do not respond within 4 months of therapy are discontinued
References
- Retrospective: Go RS, Li CY, Tefferi A, Phyliky RL. Acquired pure red cell aplasia associated with lymphoproliferative disease of granular T lymphocytes. Blood. 2001 Jul 15;98(2):483-5. link to original article PubMed
- Retrospective: Bareau B, Rey J, Hamidou M, Donadieu J, Morcet J, Reman O, Schleinitz N, Tournilhac O, Roussel M, Fest T, Lamy T. Analysis of a French cohort of patients with large granular lymphocyte leukemia: a report on 229 cases. Haematologica. 2010 Sep;95(9):1534-41. link to original article PubMed content property of HemOnc.org
- Review: Lamy T, Loughran TP Jr. How I treat LGL leukemia. Blood. 2011 Mar 10;117(10):2764-74. link to original article PubMed
- Retrospective: Moignet A, Hasanali Z, Zambello R, Pavan L, Bareau B, Tournilhac O, Roussel M, Fest T, Awwad A, Baab K, Semenzato G, Houot R, Loughran TP Jr, Lamy T. Cyclophosphamide as a first-line therapy in LGL leukemia. Leukemia. 2014 May;28(5):1134-6. Epub 2013 Nov 27. link to original article PubMed
Methotrexate +/- Prednisone
Regimen
Retrospective
- Methotrexate (MTX) 7.5 to 10 mg/m2 PO once per week (Lamy et al. 2011 divides the 10 mg/m2 methotrexate dose into 5 mg/m2 in the morning and 5 mg/m2 in the evening)
- Lamy et al. 2011: Patients with severe neutropenia (ANC < 200) receive Prednisone (Sterapred) 1 mg/kg PO once per day for one month, and then the dose is tapered to off during the second month
patients who are responding are continued on treatment until progression; patients who do not respond within 4 months of therapy are discontinued
References
- Bareau B, Rey J, Hamidou M, Donadieu J, Morcet J, Reman O, Schleinitz N, Tournilhac O, Roussel M, Fest T, Lamy T. Analysis of a French cohort of patients with large granular lymphocyte leukemia: a report on 229 cases. Haematologica. 2010 Sep;95(9):1534-41. link to original article PubMed
- Lamy T, Loughran TP Jr. How I treat LGL leukemia. Blood. 2011 Mar 10;117(10):2764-74. link to original article PubMed