Subcutaneous panniculitis-like T-cell lymphoma: complete remission with fludarabine

Subcutaneous panniculitis-like T-cell lymphoma (SPTCL) is an uncommon type of cutaneous lymphoma with an aggressive natural history. It generally carries a poor prognosis despite standard anthracycline-based chemotherapy. The optimum therapy is unknown. We report the case of a 66-year-old man with CD4/CD8 double negative SPTCL who achieved a complete remission with single-agent fludarabine. He received a total of six cycles of fludarabine given at 25 mg/m(2) daily for 5 days every 4 weeks. His skin ulcers started to heal within 2 weeks of the first cycle of chemotherapy and were completely healed before the fourth cycle. Unfortunately, he died suddenly of unknown cause 3 months after the completion of chemotherapy while remaining in complete remission. Our report suggests that fludarabine may be an active agent in SPTCL and deserves further study.