Successful treatment of lupus with fludarabine

We describe a 58-year old patient with chronic lymphocytic leukemia (CLL) w ho developed systemic lupus erythematosus (SLE) with severe joint involveme nt. Dilated myocardiopathy precluded the use of high corticoid doses and a 15 days of prednisone (15mg/d) had no effect on the polyarthritis. Therefor e, fludarabine (25mg/m(2)) was administered for 5 d. One month after the fi rst cycle, fever, muscle stiffness and polyarthritis resolved. A total of 6 cycles were administered. The evolution was complicated by herpes tester i nfection and left pneumococcal pneumonia. At this time of writing (July 199 9), the patient is symptom free but is profoundly lymphopenic.