T-cell large granular lymphocyte leukemia of donor origin after allogeneic bone marrow transplantation

Am J Clin Pathol. 2003 Oct;120(4):626-30. doi: 10.1309/VA75-5A03-PVRV-9XDT.


A 39-year-old man with chronic myeloid leukemia in accelerated phase underwent allogeneic bone marrow transplantation (BMT). At 6 months after BMT, lymphocytosis (WBC count, 23,100/microL [23.1 x 10(9)/L]; 80% (0.80) large granular lymphocytes [LGLs]) occurred. The LGLs were CD3+CD4-CD8+, with clonally rearranged T-cell receptor gamma gene, and of donor origin, as shown by analysis of polymorphic microsatellite markers. Epstein-Barr virus was not present. The diagnosis, therefore, was consistent with T-cell large granular lymphocytic (T-LGL) leukemia. Corticosteroids controlled the LGL count, but progressive pancytopenia led to death 4 months later. Retrospective analysis showed that the T-LGL leukemia apparently had arisen as early as 3 months after BMT. The distinguishing features of this case included donor origin, neoplastic nature, and the aggressive fatal outcome.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Base Sequence
  • Bone Marrow Transplantation / adverse effects*
  • Clone Cells
  • DNA Mutational Analysis
  • DNA, Neoplasm / analysis
  • Fatal Outcome
  • Humans
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive / immunology
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive / therapy*
  • Leukemia, Prolymphocytic, T-Cell / etiology
  • Leukemia, Prolymphocytic, T-Cell / genetics
  • Leukemia, Prolymphocytic, T-Cell / pathology*
  • Male
  • Microsatellite Repeats
  • Molecular Sequence Data
  • Receptors, Antigen, T-Cell, gamma-delta / genetics
  • Reverse Transcriptase Polymerase Chain Reaction
  • T-Lymphocyte Subsets
  • Tissue Donors*
  • Transplantation Chimera
  • Transplantation, Homologous


  • DNA, Neoplasm
  • Receptors, Antigen, T-Cell, gamma-delta