Third, as an immunomodulator, Thal increases cell-mediated immunity by directly stimulating cytotoxic T cells and increasing the total number of lymphocytes, as well as the CD8+ and CD4 + T-cell counts.22 The above observations support the rationale and innovation behind Thal as a treatment for LGLL. Here, CD4 is linked to T-cell large granular lymphocyte leukemia.