T-cell large granular lymphocyte leukemia (T-LGLL) is a rare clonal lymphoproliferative disorder. Because of its low incidence rate and few cases, there is no standard treatment guideline. We report on a case of T-LGLL with severe anemia [hemoglobin (HGB): 36 g/L]. After 4 months of treatment with cyclosporine A, the response was suboptimal, and the patient still had transfusion-dependent anemia (HGB: 47 g/L). After six cycles of FND (fludarabine, mitoxantrone, dexamethasone) regimen, the hematological response was complete (HGB: 143 g/L) and the monoclonal lymphocytes were nonexistent. Therefore, an FND regimen may be an option for treating refractory T-LGLL.