Leukemia Treatment Hairy Cell

Hairy cell leukemia (HCL) is a rare type of chronic leukemia. About 600 cases of HCL are diagnosed each year in the United States, according to Cancer Investigations (2008). The name refers to the characteristic shape of hairy cell leukemia cells, which look hairy when viewed under a microscope. Although scientists haven’t discovered a cure for hairy cell leukemia, the disease can be successfully controlled.

Hairy Cell Leukemia Progression

Hairy cell leukemia progresses very slowly. It’s possible to live for years after diagnosis without any symptoms of the disease. While most people eventually require hairy cell leukemia treatment, some cases of HCL never reach a point where treatment is necessary.

Chemotherapy is the initial treatment for most cases of hairy cell leukemia. Chemotherapy side effects can be severe, however, so most cases of hairy cell leukemia are only treated when symptoms develop.

Asymptomatic hairy cell leukemia (HCL without symptoms) is carefully monitored with regular checkups several times a year. Doctors may recommend treatment if the following symptoms develop:

  • Enlarged lymph nodes
  • Enlarged spleen
  • High rate of infection
  • Low blood cell counts.

Cladribine and Pentostatin

The chemotherapy drug cladribine is usually the first treatment for hairy cell leukemia. Most patients respond well to cladribine treatment, which can result in disease remission for years, although there may be chemotherapy side effects.

Pentostatin may also be used for hairy cell leukemia chemotherapy treatment. Like cladribine, pentostatin can achieve long-term disease remission. In the event of a relapse, additional chemotherapy is often successful.

Both cladribine and pentostatin can cause chemotherapy side effects. Common chemotherapy side effects associated with the two medications include:

  • Fever
  • Increased rates of infection
  • Kidney problems.

Interferon Therapy and Hairy Cell Leukemia

If chemotherapy proves to be ineffective, hairy cell leukemia may be treated with immunotherapy, which uses medication to strengthen the immune system. Immunotherapy may also be used in situations where chemotherapy is not an option.

Immunotherapy options for hairy cell leukemia include interferon therapy and rituximab. Interferon therapy uses synthetic versions of interferon, an immune system protein that slows the growth of cancer cells. Rituximab is a monoclonal antibody that binds to cancer cells, targeting cells for destruction by the immune system.

Surgery for Leukemia

Surgery for leukemia is rarely used to treat hairy cell leukemia. Occasionally, an enlarged spleen causes pain or rupture, in which case the spleen is surgically removed (a procedure called a splenectomy). Surgery for leukemia carries the same risks as other forms of surgery, including:

  • Anesthetic complications
  • Bleeding
  • Infection.

Resources

American Cancer Society. (2009). Monoclonal antibodies. Retrieved April 5, 2010, from http://www.cancer.org/docroot/ETO/content/ETO_1_4X_Monoclonal_Antibody_Therapy_Passive_Immunotherapy.asp.

American Cancer Society. (2009). Treatment of hairy cell leukemia (HCL). Retrieved April 5, 2010, from http://www.cancer.org/docroot/CRI/content/CRI_2_4_4X_Treatment_of_Hairy_Cell_Leukemia_HCL_62.asp?sitearea=.

Cannon T; Mobarek D; Wegge J; Tabbara IA. (2008). Hairy cell leukemia Current concepts. Retrieved July 14, 2010, from http://www.medscape.com/medline/abstract/18798068.

Leukemia and Lymphoma Society. (2009). Hairy cell leukemia. Retrieved April 5, 2010, from http://www.leukemia-lymphoma.org/all_page.adp?item_id=8507#_Diagnosis.

Mayo Clinic. (2010). Hairy cell leukemia: Treatment and drugs. Retrieved April 5, 2010, from http://www.mayoclinic.com/health/hairy-cell-leukemia/DS00673/DSECTION=treatments-and-drugs.

National Cancer Institute. (2010). Treatment for hairy cell leukemia. Retrieved April 5, 2010, from http://www.cancer.gov/cancertopics/pdq/treatment/hairy-cell-leukemia/HealthProfessional/page5.