Hairy-Cell Leukemia With T-Cell Features

A case of clinically and hematologically typical hairy-cell leukemia has been presented in which, at the various times of testing, 52%-95% of peripheral blood and 73% of splenic mononuclear cells formed spontaneous sheep erythrocyte (E) rosettes. Many of the resetting cells were shown to be typical morphologic hairy cells by light and electron microscopy. It was found that 70%-75% of peripheral blood mononuclear cells stained with an anti-T antiserum, and this antiserum also abolished E-rosette formation. A variable percentage of peripheral blood mononuclear cells was also shown to bear surface (IgDK) and internal (IgMK and IgGK) immunoglobulins. Additional B-cell features demonstrated included possession of the P29/34 la-like antigen and formation of mouse rosettes. It was demonstrated by a variety of blocking and inhibition studies that the E-rosette formation was not attributable to chance antigen specificity of the surface membrane immunoglobulin. These marker studies suggest that this is a case of true hybrid cell HCL. Despite these unusual marker characteristics, the patient showed no distinctive clinical or hematologic features.