text: <unk>  (also known as T-GLL) is a rare type of leukemia that exhibits an unexplained, chronic (> 6 months) elevation in<unk><unk><unk> s (LGLs) in the peripheral blood.<unk>  was first discovered by McKenna, in 1977.<unk>  may be classified into 2 groups:<unk>  (T-LGL) and natural-killer (NK)<unk><unk>  leukemia (NK-LGL). The pathogenesis of<unk>  is characterized by the involvement of cytotoxic T cells. The postulated cells of origin of T-LGL leukemia are transformed CD8+ T-cells with clonal rearrangements of β chain T-cell receptor genes for the majority of cases and a CD8- T-cell with clonal rearrangements of γ chain T-cell receptor genes for a minority of cases. The molecular pathogenesis of<unk>  is characterized by the disregulation of signaling pathways, such as: FAS/FAS-L, phosphatidylinositol-3 kinase (PI3K), and mitogen-activated proteinkinase/extracellular signal-regulated kinase (MAPK/ERK). Patients of all age groups may develop<unk> .<unk>  is more commonly observed among middle aged adults. Laboratory findings consistent with the diagnosis of<unk>  include neutropenia, anemia, hypergammaglobulinemia, and<unk> sis (most common). The diagnosis of<unk>  is made when the following diagnostic criteria is met: clonal rearrangements of the T-cell receptor (TCR) gene, chronic (> 6 months) elevation in<unk><unk><unk> s (LGLs) in the peripheral blood,<unk><unk><unk>  count greater than 2.0 × 109/L, and<unk> sis (typically 2-20x109/L). The mainstay of therapy for<unk>  is<unk> ted-chemotherapy. Initial therapy for patients with<unk>  includes corticosteroids and methotrexate. Alemtuzumab and tipifarnib are the treatment of choice for patients with refractory T-cell<unk><unk> <unk> c leukemia.
option_0: T-cell large granular lymphocyte leukemia
option_1: T-cell prolymphocytic leukemia electrocardiogram
option_2: Aggressive NK-cell leukemia
option_3: Hemophagocytic lymphohistiocytosis
option_4: Adult T-cell leukemia
option_5: B-cell prolymphocytic leukemia
option_6: T-cell prolymphocytic leukemia
option_7: Peripheral T cell lymphoma