T-cell prolymphocytic leukemia natural history, complications and prognosis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Qurrat-ul-ain Abid, M.D.[2], Maria Fernanda Villarreal, M.D. [3]

T-cell prolymphocytic leukemia is diagnosed after its symptoms appear. Failure to treat can result in multiple organ failure.

• The majority of patients with T-cell prolymphocytic leukemia are symptomatic at the time of diagnosis.
• Early clinical features include fever, fatigue, and lymphadenopathy.
• If left untreated, patients with T-cell prolymphocytic leukemia may progress to develop multiple organ failure.
• Common complications of T-cell prolymphocytic leukemia, include:^[1]

• Graft-versus-host disease (allogeneic transplant)
• Infections
• Bleeding

• Prognosis is generally poor, and the median survival time of patients with T-cell prolymphocytic leukemia is approximately one to two years.^[1]
• Patients with CD45RO+/CD45RA- immunophenotype tend to have a more indolent course.
• It seems following factors are associated with worse prognosis:
  • Increased expression of TCL1
  • Increased activity of the serine-threonine kinase AKT

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