Abstract
Hairy cell leukemia (HCL) is among a group of mature lymphoid B-cell disorders characterized by the identification of hairy cells and a unique genetic profile. Detection of CD103 expression on flow cytometry is the key in enumerating the immunologic score for diagnosing HCL. For a disease that is more prevalent in Caucasians and less common in African populations, we report an unusual case of CD103-negative classical HCL in a 43-year-old African male, who presented with refractory anemia, thrombocytopenia, and splenomegaly. In patients with refractory anemia, it is crucial to consider investigating HCL, as this may influence therapeutic decisions and, consequently, overall patient outcomes.