T cell large granular lymphocyte leukemia (T-LGL) is a chronic disease covering a wide spectrum of clinical presentations in the border-land between reactive autoimmunity and overt leukemia [1-2]. Most T-LGL patients follow an indolent course, and display a fairly uniform immunophenotype: TCR alfa/beta+, CD3+, CD4-, CD8+, CD56-, CD57+. This disease often causes significant morbidity mediated by anemia and granulocytopenia, considered to occur by mechanism of T cell cytokines. There is no consensus for optimal therapy of T-LGL, but beneficial effects have been reported for a number of agents including cyclosporin, methotrexate, cyclophosphamide and nucleoside analogs [1-2]. However, to the best of our knowledge, there is no experience with some modalities currently in use for closely related disorders. The purpose of the experiments reported in this case report was to evaluate the need for clinical studies on such therapies, including epigenetic modulation and extracorporeal photopheresis.