Successful treatment with fludarabine in two cases of angioimmunoblastic lymphadenopathy with dysproteinemia

Angioimmunoblastic lymphadenopathy with dysproteinemia (AILD) is today reco gnized as a T-cell lymphoma which in most cases runs an aggressive course. The diagnosis is often difficult because of the varying clinico-pathologica l picture. Less than a third of the patients can be expected to have long-t erm remissions even after multiagent chemotherapy. Complete remissions have been reported after the use of interferon-alpha, cyclosporin A. and recent ly purine analogues in a few patients. We now report two cases of AILD that had unmaintained remissions for 32 and 10 months, respectively, after flud arabine therapy. In one of the patients fludarabine was used up-front and i n the other after she had proved to be resistant to CHOP treatment. No seve re infectious complications were noted. The use of purine analogues should be investigated further in AILD.