Immunological evaluation after splenectomy for hairy cell leukemia--a case report.

Immunocompetence is generally reduced in patients with hairy cell leukemia (HCL), and splenectomy is advocated by many authorities as being the initial treatment of choice for HCL. A 46-year-old Japanese man with HCL underwent a splenectomy and was studied, with respect to immunological parameters, pre- and post-operatively. Preoperative analysis of the T cell subsets showed decreases in the proportions of OKT3 positive cells, OKT4 positive cells and OKT8 positive cells; a decrease in the OKT4/OKT8 ratio; and a markedly reduced lymphocyte blastic response in peripheral blood. After splenectomy, the increase in the proportion of OKT4 positive cells was greater than in that of OKT8 cells and the lymphocyte blastic response was also improved. The patient's post-operative course has been uneventful and immunological improvement is still recognizable now, 1 year after splenectomy.