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Treatment of hairy cell leukemia

Author
Martin S Tallman, MD
Section Editor
Richard A Larson, MD
Deputy Editor
Alan G Rosmarin, MD

INTRODUCTION

Hairy cell leukemia (HCL) is an uncommon chronic B cell lymphoproliferative disorder. Its name is derived from the prominent irregular cytoplasmic projections of the malignant cells [1,2]. The treatment of HCL will be reviewed here [3,4]. The pathophysiology, clinical manifestations, and diagnosis of this disorder are described separately. (See "Clinical features and diagnosis of hairy cell leukemia".)

INDICATIONS FOR TREATMENT

Many patients with hairy cell leukemia (HCL) are asymptomatic and can be observed for months or years after the diagnosis is established before requiring treatment. There is no clear advantage to early treatment; therapy is indicated only when the patient develops one or more of the following problems or symptoms [5]. There is a theoretic risk of infection in such patients, occasionally with opportunistic organisms [6-8]. (See "Clinical features and diagnosis of hairy cell leukemia", section on 'Presenting complaints'.)

Significant cytopenias; typical peripheral blood counts that warrant treatment include an absolute neutrophil count <1000/microL with repeated infections, symptomatic anemia with a hemoglobin concentration <11.0 g/dL, or bleeding due to a platelet count <100,000/microL

Symptomatic splenomegaly (common) or symptomatic adenopathy (uncommon)

Constitutional symptoms (eg, fever, night sweats, fatigue, weight loss)

                           

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Literature review current through: Nov 2016. | This topic last updated: Thu Jul 21 00:00:00 GMT 2016.
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