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

Gianluigi Reda, Bruno Fattizzo, Ramona Cassin, Elena Flospergher, Nicola Orofino, Umberto Gianelli, Wilma Barcellini, Agostino Cortelezzi

Research output: Contribution to journalArticle

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.

Original languageEnglish
Pages (from-to)1307-1310
Number of pages4
JournalOncology Letters
Volume13
Issue number3
DOIs
Publication statusPublished - Mar 1 2017

Keywords

  • Acute myeloid leukemia
  • Autoimmunity
  • Chemotherapy‑induced neutropenia
  • Chronic neutropenia
  • Natural killer chronic expansion

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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