A weekly dosage of Methotrexate (with or without daily Prednisone) may induce partial or complete response in some patients while others may require Cyclosporine or Cyclophosphamide.Alemtuzumab has been investigated for use in treatment of refractory T-cell large granular lymphocytic leukemia.Experimental data suggests that treatment with calcitrol (the active form of vitamin D) may be useful in treating T-cell LGL due to its ability to decrease pro-inflammatory cytokines. Prognosis
The 5 year survival has been noted as 89% in at least one study from France of 201 patients with T-LGL leukemia. Epidemiology
T-LGLL is a rare form of leukemia, comprising 2-3% of all cases of chronic lymphoproliferative disorders. History
LGLL was discovered in 1985 by Thomas P. Loughran Jr. while working at Fred Hutchinson Cancer Research Center. Specimens from patients with LGLL are banked at the University of Virginia for research purposes, the only bank for such purposes. References


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Prescribers should be cautious in the use of labetalol for nursing mothers.Pediatric: no studies have established safety or usefulness in this population.Geriatric: the elderly are more likely to experience dizziness when taking labetalol. Labetalol should be dosed with caution in the elderly and counseled on this side effect. Side effects
Common
Neurologic: headache (2%), dizziness (11%)
Gastrointestinal: nausea (6%), dyspepsia (3%)
Cholinergic: nasal congestion (3%), ejaculation failure (2%)
Respiratory: dyspnea (2%)
Other: fatigue (5%), vertigo (2%), orthostatic hypotensionLow blood pressure with standing is more severe and more common with IV formulation (58% vs 1%) and is often the reason larger doses of the oral formulation cannot be used. Rare
Fever
Muscle cramps
Dry eyes
Heart block
Hyperkalemia
Hepatotoxicity
Drug eruption similar to lichen planus
Hypersensitivity - which may result in a lethal respiratory distress

Contraindications
Labetalol is contraindicated in people with overt cardiac failure, greater-than-first-degree heart block, severe bradycardia, cardiogenic shock, severe hypotension, anyone with a history of obstructive airway disease including asthma, and those with hypersensitivity to the drug. Chemistry
The minimum requirement for adrenergic agents is a primary or secondary amine separated from a substituted benzene ring by one or two carbons. This configuration results in strong agonist activity. As the size of the substituent attached to the amine becomes greater, particularly with respect to a t-butyl group, then the molecule typically is found to have receptor affinity without intrinsic activity, and is, therefore, an antagonist. Labetalol, with its 1-methyl-3-phenylpropyl substituted amine, is greater in size relative to a t-butyl group and therefore acts predominantly as an antagonist. The overall structure of labetalol is very polar.