DYSERYTHROPOIETIC CHANGES AND SIDEROBLASTIC ANEMIA IN PATIENTS WITH HAIRY-CELL LEUKEMIA BEFORE AND AFTER THERAPY WITH 2-CHLORODEOXYADENOSINE

Active hairy cell leukemia is associated with an increase of RDW (Red Cell Distribution Width) which normalizes after successful therapy wit h 2-chlorodeoxyadenosine (2-CdA) [9]. To clarify this phenomenon, bone marrow films performed before therapy with 2-CdA and after its succes sful completion were subjected to careful evaluation. Dyserythropoieti c changes were present in 5 out of 17 patients before the therapy with 2-CdA. In 2 patients the changes were only slight, characterized by i rregularities of the shape of nucleus and nuclear contour, in the rema ining 3 patients the changes were marked, represented by nuclear lobul ation, karyorrhexis and binuclearity, with the presence of ringed side roblasts in one of them. After therapy with 2-CdA complete hematologic remission was achieved in 4 patients with disappearance of dyserythro poietic changes and normalization of RDW values. In the last patient w ith ringed sideroblasts despite complete remission with disappearance of tumoral cells in the bone marrow as demonstrated by immunohistochem ical analysis of trephine bone marrow biopsy with monoclonal antibody DBA 44 the condition deteriorated, RDW remained unchanged, the siderob lastic anemia progressed.