Journal Article

Clinicopathological features and treatment of aggressive natural killer cell leukemia: case series and literature review

Wang, Yuping, Sun, Lirong, Li, Lei, Ni, Yongan

2024

Overview

Background. Aggressive natural killer cell leukemia (ANKL) is rare and difficult to diagnose in early stages, with no standard treatment and a poor prognosis. Case presentation. Two adolescents with ANKL presented with hemophagocytic lymphohistiocytosis (HLH), with Case-1 presenting as refractory HLH and Case-2 with lung involvement. The morphology of bone marrow showed an increase in unidentified cells, which mainly expressed CD56. Cytogenetic analysis showed complex karyotypes. Both patients received intensive combined chemotherapy based on pegaspargase and anthracyclines. Case-1 died of tumor lysis syndrome. Case-2 underwent hematopoietic stem cell transplantation and is currently alive and disease-free. Conclusions. HLH can serve as the initial manifestation of ANKL. Leukemia cells of ANKL have significant variations in the morphology and mainly express CD56. Intensive combination chemotherapy based on pegaspargase and anthracyclines may be considered for ANKL.

• Publisher: Akdema Informatics and Publishing,Hacettepe University Faculty of Medicine,Hacettepe University Institute of Child Health
• Subject: aggressive NK cell leukemia / Analysis / Anemia / Anthracyclines / Antigens / asparaginase / Blood / Bone marrow / Cancer / Care and treatment / Chemotherapy / Chromosomes / Cytogenetics / Dehydrogenases / Diagnosis / Drug therapy, Combination / Epstein-Barr virus / Fever / Flow cytometry / Genes / Hematopoietic stem cells / Hemoglobin / hemophagocytic lymphohistiocytosis / Induction therapy / Infections / Killer cells / Leukemia / Leukocytes / Lungs / Medical prognosis / Morphology / Multiple organ dysfunction syndrome / Mutation / Neutrophils / Patients / Prognosis / Remission (Medicine) / Stem cell transplantation / Transplantation / Triglycerides / Vincristine