How would you treat an LGL leukemia patient who has been refractory to treatments with cyclosporine, MTX, and cyclophosphamide?

In my experience, true refractoriness to methotrexate and cyclophosphamide is unusual in LGL. What is more usual is that patients take a long time to respond and I usually don’t change therapy before a full 6 months trial of either agents. That is also what the published data suggests. In the meanwh...