A 45-year-old woman was admitted to our hospital in August, 1999. Laboratory data showed a white blood cell count of 5,050/microliter with 78% abnormal lymphocytes,
hemoglobin 6.8 g/dl, platelets 4.8 x 10(4)/microliter, and soluble
IL-2 receptor 97,600/ml. The abnormal cells were characterized by a hairy appearance under phase contrast microscopy, and showed strong
tartrate-resistant acid phosphatase activity. Immunophenotype analysis revealed that these cells were positive for CD11c, CD19 and CD25, and negative for CD5. Bone marrow biopsy showed diffuse proliferation of hairy cells with moderate
myelofibrosis. We diagnosed the patient as having European-American-type
hairy cell leukemia.
Pentostatin was administered at a dose of 5 mg/m2 weekly. After twelve doses, the peripheral blood data returned to the normal range with no hairy cells in the blood or bone marrow, although slight
splenomegaly remained. The patient underwent
splenectomy in December of the same year, and we were unable to find any hairy cells by histological and immunohistochemical examination. Although most patients with
hairy cell leukemia in Japan have the Japanese variant, and the European-American type is rare,
pentostatin is as effective as it is for European and American patients.