Effect of intense leukocytapheresis in pancytopenic phase of hairy cell leukemia.

The efficacy of leukocytapheresis in a pancytopenic patient with hairy cell leukemia in postsplenectomy stage is reported. Cytapheresis as the only therapy was effective on more than one occasion in inducing remission and reducing transfusion requirements. Fourteen months after the last leukocytapheresis, the patient's hemoglobin and hematocrit remain normal. The leukocyte concentrates removed contained 90 percent lymphocytes consisting of 75 percent T cells, 15 percent B cells, and only 2 to 4 percent hairy cells. Thus, the removal of a large number of lymphocytes, not necessarily hairy cells, induced a sustained clinical improvement and indicated that cytapheresis may be a useful alternative to chemotherapy for these patients.