Treatment of Hairy-Cell Leukemia with Chemoradiotherapy and Identical-Twin Bone-Marrow Transplantation

Abstract

HAIRY-CELL leukemia (leukemic reticuloendotheliosis) is a disorder in which mononuclear leukocytes with characteristic filamentous cytoplasmic villae ("hairy" cells) accumulate in peripheral blood, spleen, and bone marrow. The typical presentation includes pancytopenia and splenomegaly, with hairy cells in the peripheral blood.1 2 3 4 5 The major clinical problem is infection attributable to defects in host defense,6 7 8 9 including either granulocytopenia7 or monocytopenia6 , 8 with impairment of normal monocyte function8 , 9 or both. The clinical course is variable but usually progressive and fatal, with a median survival time of four to six years after diagnosis.1 2 3 4 5 There is no known cure for hairy-cell leukemia. Although splenectomy10 and leukapheresis11 often . . .