Thalidomide is highly effective in a patient with meningeal acute myeloid leukaemia.

We report a case of secondary acute myeloid leukaemia (AML) following high dose therapy for diffuse large B-cell non-Hodgkin's lymphoma (NHL) who developed meningeal leukaemia. This was refractory to systemic and intrathecal chemotherapy and cranial irradiation. Thalidomide has been reported to have anti-AML activity and appears to cross the blood brain barrier (BBB). We, therefore, attempted a trial of oral Thalidomide and achieved rapid biochemical and cytological remission with a short course. The patient, however, progressed systemically and succumbed to her illness.