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Treatment of hairy cell leukemia

Author
Martin S Tallman, MD
Section Editor
Richard A Larson, MD
Deputy Editor
Rebecca F Connor, MD

INTRODUCTION

Hairy cell leukemia (HCL) is an uncommon lymphoid neoplasm characterized by the accumulation of small mature B cell lymphoid cells with abundant cytoplasm and "hairy" projections within the peripheral blood, bone marrow, and splenic red pulp. This accumulation of neoplastic cells typically results in splenomegaly and a variable reduction in the production of normal red blood cells, platelets, mature granulocytes, and monocytes. The increased production of malignant cells, along with a reduction in these mature elements, results in a variety of systemic manifestations, including splenomegaly, anemia, bleeding, and an increased risk of infection.

The treatment of HCL will be reviewed here; clinical features and diagnosis of this disorder are discussed separately. (See "Clinical features and diagnosis of hairy cell leukemia".)

PRETREATMENT EVALUATION

The initial evaluation of patients with HCL must establish the precise diagnosis, the extent of disease, and the performance status of the patient. Particular attention should be paid in the history and physical examination to palpable enlargement of the spleen, liver, and/or lymph nodes and history of recent infections.

Our pretreatment evaluation also includes the following studies, some of which are performed as part of the diagnostic evaluation (see "Clinical features and diagnosis of hairy cell leukemia", section on 'Evaluation'):

Laboratory studies include a complete blood count with differential and evaluation of the peripheral smear, chemistries with liver and renal function and electrolytes, uric acid, and lactate dehydrogenase. Hepatitis B serology should be obtained, especially for patients whose planned treatment includes rituximab.

                                   
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Literature review current through: Sep 2017. | This topic last updated: Oct 17, 2017.
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