Thalidomide for the Symptomatic Large Granular Lymphocytic Leukemia

Inclusion Criteria: 1. The patient fully understands the study, voluntarily participates, and signs the informed consent form (ICF); 2. The patient must meet the diagnostic criteria for LGLL; 3. The patient can be of any gender, aged 18 years or older; 4. The patient is either untreated or not properly treated previously, or has poor efficacy (not reaching PR) or relapsed after being treated with regimens not based on methotrexate/thalidomide; 5. The patient has indications for LGLL treatment, meeting at least one of the following criteria: 1. ANC \< 0.5 × 10\^9/L, or neutropenia with recurrent infections 2. HGB \< 100 g/L or requiring red blood cell transfusions for maintenance 3. PLT \< 50 × 10\^9/L 4. Concurrent autoimmune disease requiring treatment 5. Symptomatic splenomegaly 6. Severe B symptoms (unexplained fever, temperature over 38°C; night sweats; weight loss of 10% or more within six months) 7. Pulmonary hypertension; 6. ECOG score of 0-2; 7. The patient's expected survival period is 6 months or more. Exclusion Criteria: 1. Unable to understand or follow the study procedures; 2. Diagnosed or treated for malignancies other than LGLL within the past five years; 3. Non-lymphoma-related liver or kidney function impairment: ALT \> 3 times the upper limit of normal (ULN), AST \> 3 times the ULN, total bilirubin (TBIL) \> 2 times the ULN, serum creatinine clearance \< 30 ml/min; 4. Other serious medical conditions that could affect the study (e.g., uncontrolled diabetes, gastric ulcer, other serious heart or lung diseases), with the judgment resting with the investigator; 5. Caprini thrombosis analysis score indicating high risk (Appendix 2); 6. Known history of HIV infection or active HBV infection, or any uncontrolled active systemic infection requiring intravenous antibiotics; Note: Active HBV infection is defined as: a. HBV DNA ≥ 2000 IU/ml; b. ALT ≥ 2 times the ULN; c. Exclusion of hepatitis due to the disease itself, drugs, or other causes. All three conditions must be met. If a patient initially has active HBV infection and turns into inactive HBV infection after anti-HBV treatment, they can be included in the study provided they receive adequate anti-HBV treatment. 7. Patients who have undergone major surgery (excluding lymph node biopsy) within the past 14 days or are expected to undergo major surgery during the treatment; 8. Pregnant or breastfeeding women, and women of childbearing age who are not using contraception; 9. Hypersensitivity to the drugs or their components used in the study.