{'fraction_non_alphanumeric': 0.022590361445783132, 'fraction_numerical': 0.001004016064257028, 'mean_word_length': 5.5130718954248366, 'pattern_counts': {'":': 0, '<': 0, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
Recent insights into large granular lymphocytic leukemia.

LN Large granular lymphocytic leukemia (LGLL) is an uncommon lymphoproliferation of mature cytotoxic T cells or natural killer (NK) cells. The disease is characterized by cytopenias, which contribute to the majority of the morbidity. LGLL generally affects elderly patients and is often associated with an underlying autoimmune disease, such as rheumatoid arthritis, or a malignancy, including hematologic disorders and solid tumors. Approximately one-third of patients are asymptomatic at presentation. Symptoms associated with this disease can include neutropenia with recurrent infections; splenomegaly; and B symptoms, such as fatigue, weight loss, and night sweats. An interesting aspect of LGLL concerns the pathogenesis, which is incompletely understood. The current understanding recognizes a shift in the balance of cell proliferation with expansion of cytotoxic T cells or NK cells, which can resemble a chronic reactive process. Clonal expansion and increased survival of mature T cells may be driven by chronic antigen stimulation from viral, autoimmune, or tumor antigens. Supporting this hypothesis is the frequent occurrence of LGLL in patients with underlying chronic B-cell leukemia, lymphoma, or autoimmune disease, or who underwent an allogeneic stem cell transplant. Chronic and persistent antigen exposure may lead to STAT3 activation and emergence of a dominant clone. In the case of T-cell LGLL, the cytotoxic T cells may develop survival mechanisms to avoid normal cell death. For example, STAT3 mutations confer a survival advantage, leading to accumulation of aberrant T cells in comparison with normal hematopoietic cells. This process is thought to impact the hematopoiesis of normal cells, such as neutrophils, red blood cells, and platelets. Patients often present with cytopenias or recurrent infections as a result of neutropenia or pancytopenia, and may require transfusions or growth factor support.