Treatment of Hairy Cell Leukemia

About the disease

Hairy cell leukemia is a rare type of leukemia, which develops if the bone marrow produces too many lymphocytes. Lymphocytes are white blood cells and, as part of the immune system, they are responsible for fighting various infections.

Hairy cell leukemia develops only when B cells start to divide abnormally. These B cells are a type of white blood cells that are responsible for producing antibodies and presenting antigens. Under the microscope, B cells look hairy, thus giving this condition its name. When B cells divide abnormally, the amount of red blood cells and healthy white blood cells drops.

Hairy cell leukemia usually develops very slowly and it can take years before it first manifests itself. This type of leukemia is more common in middle-aged and older people, particularly in men. Although it is possible to achieve remission, the condition cannot be cured completely. Nonetheless, people can live for years after hairy cell leukemia was first diagnosed.

Although the exact cause of hairy cell leukemia is not known, it is believed that this disease develops as a result of certain DNA mutations in the bone marrow, which lead to the abnormal production of B cells.

Symptoms

• Weakness
• Easy bruising
• Frequent infections and colds
• Weight loss
• Nausea
• Feeling full after just a few bites of food
• Pale skin
• Uncontrolled bleedings

Diagnosis

• During a general examination the doctor will check patient’s lymph nodes (enlarged lymph nodes can be indicative of leukemia) and palpate abdomen to estimate size of the spleen (this can explain why the patient feels full after only a few bites of food).
• Blood test may reveal low levels of platelets, red and white blood cells.
• Bone marrow biopsy is performed in order to examine the B cells under the microscope and determine if they are abnormal.

Treatment

• Anti-cancer chemotherapy drug pentostatin may be prescribed. This drug inhibits the division of abnormal B cells and kills already existing cancerous cells. It must be taken every three to six months to prevent the recurrence of hairy cell leukemia in the future.
• Treatment with interferon alpha may be prescribed. It is a biological treatment that is designed to prolong the period of remission by helping the immune system to fight cancerous cells and destroy them. It is usually prescribed if chemotherapy has not been successful or if the patient was not able to receive chemotherapy.
• Splenectomy is a surgical procedure whereby the spleen is removed if it is enlarged or inflamed. It also helps to normalize the blood count and to prolong the patient’s life.

Authors: Dr. Nadezhda Ivanisova, Dr. Farrukh Ahmed