Prevalence and significance of large granular lymphocytes in patients with immune thrombocytopenia

Figures & data

Table I. Baseline patient characteristics for patients with immune thrombocytopenia (ITP) with and without abnormal T-large granular lymphocytes (T-LGL).

	ITP with T-LGL N=13	ITP without T-LGL N=78
Female	7(53.8%)	35(44.9%)
Age* (mean/SD, years)	42.8/17.7	47.5/19.9
Duration of follow-up (mean/SD, years)	5.5/3.4	2.3/2.3
Nadir platelet count x 10^9/L (median/IQR)	2 (1–19)	47 (13–85)
Time from diagnosis to testing for T-LGL (median/IQR, years)	2.4 (0–7.1)	0.0 (0.1–0.8)
Number of ITP treatments received (median/IQR)	7 (5–11)	3 (2–5)
Grade 2 bleeds, n (%)^#	11(84.6%)	37(47.4%)

*age at time of enrollment

^#Classified using the ITP Bleeding Scale (IBSL)¹³

Table II. Phenotype of ITP patients with T-LGL.

	Diagnosis	T-LGL count (x10^9/L)	Phenotype of T-LGL	TCGR
# 1	Primary ITP	1.1	CD3+,CD4-, CD8+,CD57+,CD56+,CD16-	+
# 2	Secondary ITP	2.0	CD3+,CD4-,CD8-, CD57+,CD56,CD16+	+
# 3	Primary ITP	1.8	CD3+,CD4-, CD8+, CD57+,CD56+,CD16-	+
# 4	Primary ITP	0.4	CD3+,CD4+,CD8+, CD57+,CD56+,CD16-	N/A
# 5	Secondary ITP	0.52	CD3+,CD4+,CD8+, CD57+,CD56+,CD16-	+
# 6	Primary ITP	0.4	CD3+,CD4-, CD8-, CD57+,CD56+,CD16+	N/A
# 7	Primary ITP	1.3	CD3+,CD4+, CD8+, CD57+,CD56+,CD16-	N/A
# 8	Primary ITP	0.6	CD3+,CD4+, CD8+, CD57+,CD56+,CD16-	+
# 9	Primary ITP	0.1	CD3+,CD4-, CD8+, CD57+,CD56+,CD16-	+
# 10	Primary ITP	0.5	CD3+,partial CD4+, partial CD8+,CD57+,CD56+,CD16-	+
# 11	Secondary ITP	0.7	CD3+,CD4+,CD8+, CD57+,CD56+,CD16-	+
# 12	Secondary ITP	0.2	CD3+,CD4-,CD8+, CD57+,CD56-,CD16-	+
# 13	Primary ITP	1.2	CD3+,CD4-, CD8-, CD57+,CD56+,CD16-	+

*The flow cytometry test was done on multiple occasions for some patients - patient 12 had T-LGL identified only in the second test performed and patient 13 in the third test performed.

Figure 1. Selection of patients.

Table III. Characteristics of patients with T-LGL who were treated with methotrexate (MTX).

Cases	Age/Sex	N. of treatments prior to T-LGL abnormality	TCGR	History of severe bleedings	Duration of MTX treatment (months)	T-LGL count before/after MTX (x10^9/L)	Plt before/during MTX treatment (x10^9/L)	Current treatment
#1 Primary ITP	66/M	8	+	Yes	4	1.1/1.1	9/4	None
#2 Primary ITP	28/F	6	+	Yes	8	0.1/0.1	2/5	Romiplostin
#3 Secondary ITP – Sjogren Syndrome	53/F	5	+	Yes	7	2.0/0.8	123/316	Romiplostin
#4 Secondary ITP – Autoimmune hepatitis	56/F	9	+	Yes	3	3.2/N/A	2/2	None

MTX: Methotrexate