Successful treatment of refractory angioimmunoblastic T-cell lymphoma with thalidomide and dexamethasone

Angioimmunoblastic T cell lymphoma (AITL) is a peripheral T-cell lymphoma characterized morphologically by lymphadenopathy with a polymorphic infiltrate, marked vascular and follicular dendritic cell proliferation. Patients usually present with advanced disease and the overall prognosis is poor. While intensive chemotherapy has been shown to induce complete remissions in 50-70% of patients, the majority of patients subsequently relapse. Herein we report the case of a 32 year old man with AITL who was refractory to conventional chemotherapy, but achieved a remarkable sustained response to treatment with thalidomide and dexamethasone. Thalidomide may be an effective therapeutic agent against AITL, and given the poor prognosis of AITL, prospective clinical studies with either thalidomide or one of the thalidomide analogues are warranted.