Neutropenia in the setting of acute hematological malignancies may impact disease prognosis, thus affecting therapy dose intensity. This is often due to chemotherapy‑induced aplasia as well as to the disease itself. However, chronic neutropenia deserves further investigation, as the management of reversible concomitant causes may avoid treatment delay. The present study describes a case of an acute promyelocytic leukemia patient with chronic severe neutropenia of multifactorial origin, including acute leukemia itself, chemotherapy, autoimmune activation with anti‑platelets and anti‑neutrophil antibodies positivity, and the rare association of large granular lymphocyte (LGL) expansion. As neutropenia may challenge the diagnosis and treatment of acute malignancies, clinicians and hematopathologists must discuss the differential diagnosis in order to avoid misdiagnosing and undertreating concomitant diseases. In particular, LGL chronic expansion and autoimmunity should be considered.

Multifactorial neutropenia in a patient with acute promyelocytic leukemia and associated large granular lymphocyte expansion: A case report / G. Reda, B. Fattizzo, R. Cassin, E. Flospergher, N. Orofino, U. Gianelli, W. Barcellini, A. Cortelezzi. - In: ONCOLOGY LETTERS. - ISSN 1792-1074. - 13:3(2017), pp. 1307-1310.

Multifactorial neutropenia in a patient with acute promyelocytic leukemia and associated large granular lymphocyte expansion: A case report

G. Reda
Primo
;
B. Fattizzo
;
R. Cassin;N. Orofino;U. Gianelli;A. Cortelezzi
Ultimo
2017

Abstract

Neutropenia in the setting of acute hematological malignancies may impact disease prognosis, thus affecting therapy dose intensity. This is often due to chemotherapy‑induced aplasia as well as to the disease itself. However, chronic neutropenia deserves further investigation, as the management of reversible concomitant causes may avoid treatment delay. The present study describes a case of an acute promyelocytic leukemia patient with chronic severe neutropenia of multifactorial origin, including acute leukemia itself, chemotherapy, autoimmune activation with anti‑platelets and anti‑neutrophil antibodies positivity, and the rare association of large granular lymphocyte (LGL) expansion. As neutropenia may challenge the diagnosis and treatment of acute malignancies, clinicians and hematopathologists must discuss the differential diagnosis in order to avoid misdiagnosing and undertreating concomitant diseases. In particular, LGL chronic expansion and autoimmunity should be considered.
Acute myeloid leukemia; Autoimmunity; Chemotherapy‑induced neutropenia; Chronic neutropenia; Natural killer chronic expansion; Oncology; Cancer Research
Settore MED/15 - Malattie del Sangue
2017
http://www.spandidos-publications.com/ol/13/3/1307/download
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/502054
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