Erythrokinetic Studies in Hairy-Cell Leukaemia

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Abstract
Erythrokinetics were studied in 29 patients with hairy cell leukemia. In all cases there was an increase in plasma volume, closely correlated to the size of the spleen, indicating that the true degree of anemia can only be appreciated by red cell volume measurement. Moderately increased hemolysis was observed in most cases, which did not correlate with the spleen size. Simultaneous study of autologous and isologous red cell life-span suggested an extra-corpuscular mechanism for the hemolysis in most patients. A quantitative erythropoietic defect, either relative or absolute, was found in 1/2 the cases, without any qualitative defect. Only 1 case showed erythroid metaplasia of the spleen. Thus marrow failure appears to be largely responsible for the anemia and granulocytopenia in hairy-cell leukemia. A clear correlation was shown between the short-term prognosis after splenectomy and the degree of hypersplenism. Long-term survival correlated chiefly with the degree of bone marrow failure, whether splenectomy was carried out or not. Isotope studies in hairy-cell leukemia apparently are useful both in determining the best form of treatment and predicting survival.