T-cell large granular lymphocyte (T-LGL) leukemia is clinically indolent, but is associated with severe @entity1398 in approximately 50% of cases. The pathogenesis of the @entity1398 is unclear. We report reversal of severe @entity1398 associated with @entity4751 in five @entity1 treated with @entity205 ( @entity870 ). All five had persistent neutrophil counts below 0.5 x 10(9)/L, two had @entity3028 , and four had recurrent infections. Increased populations of LGL were present in blood and marrow, with a T-LGL immunophenotype (CD3(+)CD8(+)CD16(+/-)CD56(+/-)CD57(+)) shown by multiparameter flow cytometry, and clonal @entity6057 ( @entity6057 ) gene rearrangements in two of two pretreatment blood samples studied. @entity870 was initiated at doses of 1 to 1.5 mg/kg orally every 12 hours, with subsequent dose adjustments based on trough serum levels. Four @entity1 attained normal neutrophil counts with @entity870 alone; one required addition of low-dose granulocyte-macrophage colony-stimulating factor. Time to attainment of 1.5 x 10(9)/L neutrophils ranged from 21 to 75 days. Attempts to taper and withdraw @entity870 resulted in recurrent @entity1398 . Three @entity1 have maintained normal neutrophil counts on continued @entity870 therapy for 2, 8, and 8.5 years. Two @entity1 died 1.7 and 4.6 years after initiation of @entity870 despite normal neutrophil counts-one of metastatic @entity320 and one of complications after aortofemoral bypass surgery. Despite resolution of @entity1398 , increased populations of T-LGL cells have persisted in all @entity1 during @entity870 therapy, as shown by morphology and flow cytometry and by the presence of clonal @entity6057 gene rearrangements in four @entity1 ' posttreatment blood samples. We conclude that @entity870 is an effective therapy for @entity1398 associated with @entity4751 , and that resolution of @entity1398 despite persistence of abnormal cells implies that @entity870 may inhibit T-LGL secretion of yet unidentified mediators of @entity1398 .

@entity1398 associated with @entity4751 : long-term response to XXXX therapy despite persistence of abnormal cells.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity870 :: ('CHEBI:55379', 'Chemical') :: ['CSA'] @entity4751 :: ('MESH:D054066', 'Disease') :: ['T-LGL leukemia'] @entity6057 :: ('6962', 'Gene') :: ['TCR', 'T-cell receptor'] @entity205 :: ('MESH:D016572', 'Chemical') :: ['cyclosporine'] @entity1398 :: ('MESH:D009503', 'Disease') :: ['neutropenia'] @entity3028 :: ('MESH:D000380', 'Disease') :: ['agranulocytosis'] @entity320 :: ('MESH:D008545', 'Disease') :: ['melanoma']
@entity205 :: (MESH:D016572,Chemical) :: ['cyclosporine']
