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Response to splenectomy in 65 patients with hairy cell leukemia: an
evaluation of spleen weight and bone marrow involvement
HM Golomb and JW Vardiman
Sixty-five patients with hairy cell leukemia underwent splenectomy; 27 had
a complete remission as defined by a return in WBC, RBC, and platelet
counts to a defined level, and 38 had a partial remission with a return of
only one or two of these parameters to the defined level. The 5-yr
actuarial survival for all patients is 68%; for CR patients it is 76%, and
for PR patients 62%. The response to splenectomy did not correlate with the
spleen weight. Seventeen patients had a postsplenectomy platelet count of
less than 200 x 10(9)/liter, and 34 patients had a postsplenectomy platelet
count of 200 x 10(9)/liter or greater. A presplenectomy bone core biopsy
hairy cell index (HCI) was calculated by multiplying the percent marrow
cellularity by the percent of hairy cells in the marrow for 51 patients.
The difference in the mean HCI between the two platelet response groups is
statistically significant (p less than 0.05). Of the 15 patients with a
presplenectomy HCI of 0.7 or greater, 9 (60%) did not have a satisfactory
platelet response to splenectomy, whereas of 36 patients with an HCI of 0.7
or less, only 8(22%) did not have a satisfactory platelet response to
splenectomy (p less than 0.01). The HCI appears to indicate the
significance of underproduction of platelets as a result of marrow
replacement by hairy cells.
Volume 61,
Issue 2,
pp. 349-352,
02/01/1983
Copyright © 1983 by The American Society of Hematology
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