A Case of Natural Killer-Large Granular Lymphocyte (NK-LGL) Leukemia / 대한혈액학회지

Large granular lymphocyte (LGL) leukemia, a rare hematologic malignancy, is classified into two groups, CD3+ T-LGL leukemia and CD3- NK-LGL leukemia based upon immunophenotype of the cells. We describe a patient with NK-LGL leukemia, who showed a rapidly fatal course. A 56-year-old man was presented with a very high count of white blood cells (154,400/mm3) consisting of mostly LGLs. Immunophenotyping using flow cytometric analysis revealed that majority of the cells were positive for HLA-DR and CD56 but negative for all the myeloid and lymphoid markers. Despite of active supportive care, he died of coagulopathy and multi-organ failure on the sixth hospital day.

Effects of Short-Term Incubation of Hematopoietic Cells with Hematopoietic Growth Factors on CXCR4 Expression and Stromal Cell-Derived Factor-1-Mediated Transendothelial Migration / 대한혈액학회지

BACKGROUND: There has been contradictory reports regarding the homing potential of hematopoietic cells briefly exposed to hematopoietic growth factors in vitro. To get a resolution to this controversy, we investigated the effects of short-term growth factor treatment of hematopoietic cells on the expression of CXCR4 and adhesion molecules, and the chemotaxis in response to stromal cell-derived factor-1 (SDF-1), which is widely accepted to play a critical role in bone marrow (BM) homing of hematopoietic stem cells. METHODS: BM and cord blood(CB) CD34+ cells were incubated with various hematopoietic growth factors including IL-1beta, IL-3, IL-6, G-CSF, GM-CSF, stem cell factor (SCF), flk-2 ligand, and thrombopoietin, alone or in combination for up to 48 hours. Before and after the incubation, the expression of CXCR4 and adhesion molecules of CD34+ cells was analyzed using flow cytometry. SDF-1-mediated transmembrane or transendothelial migration of CD34+ cells, cobblestone area-forming cells (CAFCs), and/or long-term culture-initiating cells (LTC-ICs) was measured using Transwell(TM) system. RESULTS: VLA-4 was moderately up-regulated by the incubation of the cells with IL-3 and SCF, and ICAM-1 was slightly up-regulated by IL-1 and IL-3. The expression of L-selectin, PECAM-1 or LFA-1 was not altered by any growth factors. With the incubation of the cells in the absence of growth factors or SDF-1, CXCR4 expression of CD34+ cells was rapidly increased, reaching a plateau at 24 hours. The spontaneous up-regulation was abrogated with the addition of SDF-1. In agreement with the up-regulation of CXCR4, CD34+ cells incubated for 40 hours showed much enhanced chemotaxis in response to SDF-1 compared to non-incubated cells (24.7 3.5% vs. 7.0 1.6%, P=0.01). Any growth factors examined in this study did not alter the CXCR4 expression of CD34+ cells. Neither did growth factors affect the transendothelial migration of LTC-ICs toward bone marrow stromal cells as well as the SDF-1-induced transmembrane chemotaxis of CD34+ cells and CAFCs. CONCLUSION: Short-term treatment of hemo-topoietic cells with hematopoietic growth factors does not alter the expression of CXCR4 or SDF-1-mediated transendothelial chemotaxis.