Treatment of hairy cell leukemia (leukemic reticuloendotheliosis) II. Chlorambucil therapy in postsplenectomy patients with progressive disease

Four postsplenectomy patients with progressive hairy cell leukemia were treated with daily low doses of an alkylating agent (chlorambucil, 4 mg). An objective response, measured by improvement in blood counts in four patients as well as decreased bone marrow involvement on core biopsy in three patients, could be documented within 6 mo. It is important to identify the postsplenectomy patient with progressive disease as early as possible in order to initiate low-dose single agent chemotherapy and have the time necessary to effect an objective response.