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Treatment of T-Large Granular Lymphocyte (T-LGL) Lymphoproliferative Disorders With Cyclosporine
This study has been completed.
Sponsored by: National Heart, Lung, and Blood Institute (NHLBI)
Information provided by: National Institutes of Health Clinical Center (CC)
ClinicalTrials.gov Identifier: NCT00001533
  Purpose

T Cell Large Granular Lymphocyte (T-LGL) Lymphoproliferative Disorders are a heterogeneous group of uncommon diseases which may involve a polyclonal or a monoclonal T cell population, which bear characteristic surface markers corresponding to activated cytotoxic (CD3+, CD8+) lymphocytes. They are often associated with quite severe neutropenia, anemia, and thrombocytopenia which may be life-threatening. There is some evidence that the abnormal cytotoxic lymphocyte population may cause the cytopenias by suppressing hematopoiesis, although the mechanism is unclear. Case reports suggest that immunosuppressive therapy directed toward T cells may reverse the cytopenia. This pilot study involving up to 25 patients evaluates the clinical response to cyclosporine, an immunosuppressive drug, and seeks to elucidate the mechanism underlying the cytopenia.


Condition Intervention Phase
Anemia
Leukemia, T-Cell
Lymphocytosis
Neutropenia
Thrombocytopenia
Drug: cyclosporine
Phase I

MedlinePlus related topics: Anemia Leukemia, Adult Acute Leukemia, Adult Chronic Leukemia, Childhood
Drug Information available for: Cyclosporin Cyclosporine
U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment, Safety Study
Official Title: Treatment of T-Large Granular Lymphocyte (T-LGL) Lymphoproliferative Disorders With Cyclosporine

Further study details as provided by National Institutes of Health Clinical Center (CC):

Estimated Enrollment: 25
Study Start Date: September 1996
Estimated Study Completion Date: September 2000
Detailed Description:

T Cell Large Granular Lymphocyte (T-LGL) Lymphoproliferative Disorders are a heterogeneous group of uncommon diseases which may involve a polyclonal or a monoclonal T cell population, which bear characteristic surface markers corresponding to activated cytotoxic (CD3+, CD8+) lymphocytes. They are often associated with quite severe neutropenia, anemia, and thrombocytopenia which may be life-threatening. There is some evidence that the abnormal cytotoxic lymphocyte population may cause the cytopenias by suppressing hematopoiesis, although the mechanism is unclear. Case reports suggest that immunosuppressive therapy directed toward T cells may reverse the cytopenia. This pilot study involving up to 25 patients evaluates the clinical response to cyclosporine, an immunosuppressive drug, and seeks to elucidate the mechanism underlying the cytopenia.

  Eligibility

Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Patients must be greater than or equal to 18 years of age.

Peripheral blood absolute LGL count of greater than or equal to 300/ul (performed on a manual differential), with LGL cells having the characteristic appearance of large lymphocytes with abundant pale blue cytoplasm, with or without a perinuclear clear zone, with varying degrees of azurophilic granules.

Immunophenotypic studies of peripheral blood showing an increased population of T-LGL (Staining for: CD3, CD8, and either CD16 or CD57+/- CD56).

Severe neutropenia (less than or equal to 500 neutrophils/uL of peripheral blood), or severe thrombocytopenia (less than or equal to 20,000 platelets/uL, or moderate thrombocytopenia (less than or equal to 50,000 platelets/uL with active bleeding , or anemia (hemoglobin less than or equal to 9 gm/dL), or red blood cell transfusion requirement of greater than or equal to 2 units/month for two months prior to initiation of CsA treatment.

Patients must not have had previous treatment with CsA or FK506.

Patients must not have a reactive LGL lymphocytosis to a viral infection.

Patients must not have a ECOG performance status of greater than 3.

Patients must not be currently pregnant, or unwilling to take oral contraceptives unless postmenopausal.

Mothers must not be breast feeding.

Patients must be able to give informed consent.

Patients must not be HIV positive.

  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00001533

Locations
United States, Maryland
National Heart, Lung and Blood Institute (NHLBI)
Bethesda, Maryland, United States, 20892
Sponsors and Collaborators
  More Information

Publications:
Study ID Numbers: 960142, 96-H-0142
Study First Received: November 3, 1999
Last Updated: July 14, 2006
ClinicalTrials.gov Identifier: NCT00001533  
Health Authority: United States: Federal Government

Keywords provided by National Institutes of Health Clinical Center (CC):
Anemia
Chronic T Cell Lymphocytosis with Neutropenia
Immunosuppression
Neutropenia
T-LGL Leukemia

Study placed in the following topic categories:
Large granular lymphocyte leukemia
Leukemia, Lymphoid
Cyclosporine
Immunoproliferative Disorders
Clotrimazole
Hematologic Diseases
Miconazole
Blood Platelet Disorders
Tioconazole
Agranulocytosis
Anemia
Leukocyte Disorders
Cyclosporins
Granulocytopenia
Thrombocytopathy
Leukemia
Neutropenia
Lymphatic Diseases
Thrombocytopenia
Lymphocytosis
Leukemia, T-Cell
Leukopenia
Lymphoproliferative Disorders
Leukemia, Large Granular Lymphocytic

Additional relevant MeSH terms:
Anti-Infective Agents
Neoplasms by Histologic Type
Immune System Diseases
Molecular Mechanisms of Pharmacological Action
Immunologic Factors
Physiological Effects of Drugs
Enzyme Inhibitors
Immunosuppressive Agents
Pharmacologic Actions
Neoplasms
Leukocytosis
Antifungal Agents
Therapeutic Uses
Antirheumatic Agents
Dermatologic Agents

ClinicalTrials.gov processed this record on January 15, 2009