Dear Editor, T-cell non-Hodgkin’s lymphomas (NHLs) are a group of heterogeneous diseases with more aggressive behavior and dismal outcome than B-cell NHLs and account for less than 10% of the cases of aggressive NHLs in Western countries [1]. The outcome of T-cell NHL is even worse when it occurs in combination with hemophagocytic lymphohistiocytosis (HLH); this combination presents with fever, cytopenia, liver dysfunction, hepatosplenomegaly, hypertriglyceridemia, and hyperferritinemia [2, 3]. We report the case of a patient who had angioimmunoblastic T-cell lymphoma (AITL) and HLH and was successfully treated by allogeneic hematopoietic stem cell transplant (HSCT) with a reduced-intensity conditioning (RIC) regimen. The patient was a 62-year-old woman who did not have any other systemic diseases and presented with fever of up to 38.5°C of 1-week duration; she lost 20 kg in 6 months as well. Physical examination showed neck lymph node enlargement and hepatosplenomegaly. Abdominal computed tomography showed hepatosplenomegaly and retroperitoneal lymphadenopathy. Cervical lymph node biopsy was performed and the biopsy specimen showed heterogeneous infiltration of medium-sized atypical lymphocytes, with proliferation of post-capillary venules (Fig. 1a) and features of hemophagocytosis (Fig. 1b); it was immunohistochemically positive for CD3 and CD4, but negative for CD8, CD30, CD56, and CD20. AITL was diagnosed on the basis of these biopsy results. In situ hybridization detected Epstein–Barr virus-encoded RNA. Bone marrow examination showed prominent hemophagocytosis, but without evidence of lymphoma involvement. The patient had normal prothrombin time, activated partial thromboplastin time, fibrinogen levels, and liver and renal functions. However, the presence of anemia (hemoglobin 8.4 gdl, reference range 12–14), hyperferritinemia (ferritin 26,400 μg l, reference range 10– 120), elevated lactate dehydrogenase (673 Ul, reference range 120–240), hypertriglyceridemia (triglyceride 278 mg dl, reference range <200), and profound hemophagocytosis in both lymph nodes and bone marrow confirmed that she had HLH. We initiated treatment with one cycle of cyclophosphamide, adriamycin, vincristine, and prednisolone (CHOP), but the fever recurred in 2 weeks. Salvage chemotherapy with one cycle of etoposide, methylprednisolone, cytarabine, and cisplatin (ESHAP) and two cycles of mesna, ifosfamide, mitoxantrone, and etoposide (MINE) was administered. Her cervical lesions partially responded to these treatments; however, positron emission tomography and computed tomography detected a new nodular lesion in the patient’s J.-T. Yu :W.-L. Hwang : C.-L. Teng (*) Division of Hematology/Oncology, Department of Medicine, Taichung Veterans General Hospital, 160, Section 3, Chungkang Road, Taichung 407, Taiwan e-mail: drteng@vghtc.gov.tw