Oncotarget

Reviews:

Large granular lymphocytosis after transplantation

Zhi-Yuan Qiu, Guang-Yu Tian, Zhao Zhang, Ye-Qing Zhang _, Wei Xu and Jian-Yong Li

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Oncotarget. 2017; 8:81697-81708. https://doi.org/10.18632/oncotarget.21009

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Abstract

Zhi-Yuan Qiu1,*, Guang-Yu Tian1,4,*, Zhao Zhang1, Ye-Qing Zhang2, Wei Xu3 and Jian-Yong Li3

1Department of Oncology, The Affiliated People's Hospital of Jiangsu University, Zhenjiang 212002, Jiangsu, China

2Department of Vascular Surgery, The Second Affiliated Hospital of Soochow University, Suzhou 215004, Jiangsu, China

3Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, China

4Department of Oncology, People's Hospital of Jiangdu, Yangzhou 225200, Jiangsu, China

*These authors contributed equally to this work

Correspondence to:

Ye-Qing Zhang, email: 595447734@qq.com

Jian-Yong Li, email: lijianyonglm@medmail.com.cn

Keywords: large granular lymphocyte, lymphocytosis, transplantation

Received: June 14, 2017     Accepted: August 28, 2017     Published: September 18, 2017

ABSTRACT

Post-transplant lymphoproliferative disorders (PTLD) represent a heterogeneous group of diseases that occur following transplantation. Large granular lymphocytic (LGL) lymphocytosis is one type of PTLD, ranging from reactive polyclonal self-limited expansion to oligo/monoclonal lymphocytosis or even to overt leukaemia. LGL lymphocytosis in transplant recipients may present as a relatively indolent version of the condition and may be more common than reported, but its natural history and clinical course have not been well described, and the lack of a reliable classification system has limited studies on this disease. Patients with unexplained cytopenias, autoimmune manifestations, or unexpected remissions may be mislabelled. The purpose of this review was to evaluate the clinical features, immunophenotypes, etiopathogenesis, diagnosis, outcomes and treatment of post-transplantation LGL lymphocytosis. In conclusion, LGL lymphocytosis is a frequent occurrence after transplantation that correlates with certain procedural variables and post-transplant events. LGL lymphocytosis should be considered in patients with unexplained lymphocytosis or when pancytopenia develops after transplantation. The diagnosis of LGL lymphocytosis requires a demonstration of monoclonality, but clonality does not indicate malignancy. Additional studies are necessary to further delineate the potential effects of large granular lymphocytes in the long-term prognosis of post-transplant patients.


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