Hairy-cell leukemia typically presents with a reduction in normal peripheral blood cells and variable numbers of circulating mononuclear cells with prominent cytoplasmic projections. The blood changes are usually associated with effacement of bone-marrow architecture by a diffuse mononuclear cell infiltrate and a characteristic pattern of increased delicate fibrosis seen on marrow
biopsy (1–3). During the past 3 years, four patients with hairy-cell leukemia have been referred to our departments with peripheral blood cytopenias but bone-marrow hypoplasia of such degree that they were originally diagnosed as having aplastic anemia. This presentation has not been described previously.
Three patients presented with anemia