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A 57-year-old man presents with fatigue and dyspnea on exertion. Initial laboratory workup shows hemoglobin 1 0.5 g/dl with an MCV of 85 fl. leukocyte count 11 .2 00/ .uL. and platelet count 1 67 ,000/ .uL. No lymphadenopathy or splenomegaly was noted on physical exam. Peripheral blood smear is shown below.
All of the following choices are appropriate first- or second -line therapy in LGL leukemia except:
- CHOP chemotherapy
- Methotrexate
- Prednisone
- Cyclophosphamide
- Cyclosporine
Medicine
A. Although there is no gold standard therapy for LGL, immunosuppressive agents, includ-ing methotrexate, corticosteroids, cyclophosphamide, and cyclosporine, have been utilized. The most common indication for treatment is recurrent infection. There is no role for CHOP chemotherapy (Blood. 20 1 1;117(10):2764-2774).
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