Mixed-phenotype large granular lymphocytic leukemia (LGLL): a rare subtype in the LGLL Spectrum

Large granular lymphocytic leukemia (LGLL) is a chronic proliferation of cytotoxic lymphocytes in which over 70% of patients develop cytopenia(s) requiring therapy. LGLL includes T-cell LGLL (T-LGLL) and chronic lymphoproliferative disorder of NK-cells (CLPD-NK). The neoplastic cells in LGLL usually exhibit a single immunophenotype in a patient, with CD8-positive/αβ T-cell type being the most common, followed by NK-cell, γδ T-cell, and CD4-positive/αβ T-cell types. We investigated a total of 220 LGLL cases and identified 12 mixed-phenotype LGLLs (5%): 7 cases with coexistent αβ T-cell and NK-cell clones and 5 with coexistent αβ and γδ T-cell clones.

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