Hairy-Cell Leukemia Presenting as Aplastic Anemia

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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

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