{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T18:42:16Z","timestamp":1793472136435,"version":"4.5.0"},"reference-count":20,"publisher":"BMJ","issue":"7","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J Clin Pathol"],"accepted":{"date-parts":[[2019,11,25]]},"published-print":{"date-parts":[[2020,7]]},"abstract":"<jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>The causes and diagnosis of \u2018double-negative\u2019 (CD3+CD4\u2212CD8\u2212) T-cell lymphocytosis are not well studied. We aimed to define the causes of double-negative T-cell lymphocytosis in children and adults, and to identify simple clinical and laboratory features that would help to differentiate between the underlying conditions.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We collected clinical and laboratory data on 10 children and 30 adults with significantly increased peripheral-blood double-negative T-cells (&gt;10% of total lymphocytes). We identified conditions associated with double-negative T-lymphocytosis with flow cytometry, peripheral-blood morphology and T-cell receptor-gene rearrangement studies. Patients were assigned to diagnostic categories on the basis of these test results.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results and conclusions<\/jats:title>\n                  <jats:p>The causes of double-negative T-cell lymphocytosis in children were autoimmune lymphoproliferative syndrome (ALPS) and reactive \u03b3\/\u03b4 \u03a4-lymphocytosis. T-cell large granular lymphocyte (T-LGL) leukaemia, reactive \u03b3\/\u03b4 T-lymphocytosis and hepatosplenic T-cell lymphoma (HSTL) were the the most common disorders underlying double-negative T-cell lymphocytosis in adults. Less common causes included hypereosinophilic syndrome, peripheral T-cell lymphoma, ALPS and monoclonal, double-negative T-lymphocytosis of uncertain significance. CD5\/CD7\/V\u03b42 expression and absolute double-negative lymphocyte count (&lt;1.8\u00d710<jats:sup>9<\/jats:sup>\/L) were useful discriminators for distinguishing patients with reactive \u03b3\/\u03b4 T-lymphocytosis from those with \u03b3\/\u03b4 lymphoproliferative disorders. Differentiating between \u03b3\/\u03b4 T-LGL and HSTL can be difficult. Expression of CD57 and cellular morphology (pale cytoplasm with distinct granules) would support a diagnosis of \u03b3\/\u03b4 T-LGL.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/jclinpath-2019-206255","type":"journal-article","created":{"date-parts":[[2019,12,6]],"date-time":"2019-12-06T17:15:21Z","timestamp":1575652521000},"page":"431-438","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":13,"title":["Causes of double-negative T-cell lymphocytosis in children and adults"],"prefix":"10.1136","volume":"73","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1165-9639","authenticated-orcid":false,"given":"Konstantinos","family":"Liapis","sequence":"first","affiliation":[{"name":"Department of Clinical Haematology, Peripheral General Hospital Athens Giorgos Gennimatas, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikolaos J","family":"Tsagarakis","sequence":"additional","affiliation":[{"name":"Department of Immunology, Peripheral General Hospital Athens Giorgos Gennimatas, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fotis","family":"Panitsas","sequence":"additional","affiliation":[{"name":"Department of Haematology, General University Hospital of Larisa, Larissa, Thessaly, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Taparkou","sequence":"additional","affiliation":[{"name":"Paediatric Immunology and Rheumatology Referral Center, First Department of Paediatrics, Aristotle University of Thessaloniki, Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ioannis","family":"Liapis","sequence":"additional","affiliation":[{"name":"Department of Haematology, University Hospital of Crete, Heraklion, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christophoros","family":"Roubakis","sequence":"additional","affiliation":[{"name":"Department of Haematology, Metaxa Cancer Hospital of Piraeus, Piraeus, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dimitris","family":"Tsokanas","sequence":"additional","affiliation":[{"name":"Department of Clinical Haematology, Peripheral General Hospital Athens Giorgos Gennimatas, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paraskevi","family":"Vasileiou","sequence":"additional","affiliation":[{"name":"Department of Flow Cytometry, Flowdiagnosis Diagnostic Center, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eirini","family":"Grigoriou","sequence":"additional","affiliation":[{"name":"Flow Cytometry Laboratory, Department of Immunology and Histocompatibility, Evangelismos Athens General Hospital, Athens, 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