PMC9885080_01
Microscopic morphology of the clonal gammadeltaT cell subtype. (A, B) show single cells found in a peripheral blood smear and show clear morphological characteristics; (C, D) are clustered cells found in the bone marrow aspirate smear with clear cytoplasmic protrusions.
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Flow cytometry revealed the proliferation of gammadeltaT cells in the peripheral blood and bone marrow, accounting for 14.075% and 11.162% of all nucleated cells, respectively ( Supplementary Figures S1 ,  S2 ). TCR rearrangement, a characteristic population of lymphoid cells was found in the peripheral blood and bone marrow smears ( Figures 1A-D ). These cells were not prominent and thus easily overlooked in the initial microscopic examination.
(A) The timeline of the case. (B) The change in the patient's hemoglobin levels and gammadeltaT cell percentage in the total T-cell component in the peripheral blood sample over 10 months.
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Flow cytometry revealed the proliferation of gammadeltaT cells in the peripheral blood and bone marrow, accounting for 14.075% and 11.162% of all nucleated cells, respectively ( Supplementary Figures S1 ,  S2 ). The patient's peripheral blood hemoglobin level increased from 37 to 95 g/L after 10 months of treatment, and his gammadeltaT cell percentage decreased from 14.075% to 6.637% ( Figure 2B ). The timeline of this case is demonstrated in  Figure 2A .