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Fludarabine, mitoxantrone and dexamethasone as first-line treatment for T-cell large granular lymphocyte leukemia

Leukemia volume 21, pages 2225–2226 (2007)Cite this article

A Corrigendum to this article was published on 21 November 2007

There is currently no consensus on the optimal treatment of T-cell large granular lymphocyte (T-LGL) leukemia. Conventional treatment including oral methotrexate, cyclophosphamide and cyclosporine may be effective.1 However, once the usage of these drugs is stopped, relapses are very frequent. Therefore, a drawback of conventional drugs is the long-term treatment. In fact, it has been suggested that therapy should last indefinitely in responders.1 Continuous immunosuppression is worrisome, and secondary malignancies have been reported in T-LGL leukemia patients on prolonged treatment with methotrexate and cyclosporine.2

A finite treatment giving a durable remission is an important goal in leukemia therapy. We have previously reported the efficacy of the regimen FND (fludarabine intravenously, 25 mg/m2/day × 3; mitoxantrone intravenously, 10 mg/m2/day × 1; dexamethasone orally, 20 mg/day × 5; repeated every 4 weeks for six courses with cotrimoxazole prophylaxis) in inducing remissions in therapy-refractory T-LGL leukemia.3 An update of that series of nine patients at a median follow-up of 71 (12–83) months showed that two patients were in continuous remission for 6 and 7 years, without additional maintenance treatment.

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Authors and Affiliations

  1. Department of Medicine, Queen Mary Hospital, Hong Kong, China

    E Tse, A Pang, W-Y Au, A Y H Leung & Y-L Kwong

  2. Department of Medicine, Pamela Youde Nethersole Eastern Hospital, Hong Kong, China

    J C W Chan

  3. Department of Pathology, Queen Mary Hospital, Hong Kong, China

    C C K Lam

Authors
  1. E Tse
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  2. J C W Chan
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  3. A Pang
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  7. Y-L Kwong
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Correspondence to Y-L Kwong.

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Tse, E., Chan, J., Pang, A. et al. Fludarabine, mitoxantrone and dexamethasone as first-line treatment for T-cell large granular lymphocyte leukemia. Leukemia 21, 2225–2226 (2007). https://doi.org/10.1038/sj.leu.2404767

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