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Hairy Cell Luekemia

The Wake Forest Baptist Approach Our Leukemia Program, which began in 1986, is widely recognized for excellence in patient care, teaching and clinical research. As one of the largest adult leukemia services in the Southeast, we are active in national research studies. Active collaboration between basic science laboratory research faculty and our own clinical researchers ensures that patients are offered cutting edge therapies. Among the research studies currently underway is a clinical trial evaluating the use of arsenic trioxide as part of a front line therapy for patients with acute promyelocytic leukemia (APL), a subtype that accounts for approximately 10 percent of all acute myeloid leukemia.  This research study is sponsored by Cancer and Leukemia Group B (CALGB), one of three major adult national cancer research groups. In addition to access to the latest treatments, some of the multidisciplinary services offered for our leukemia patients are nutritional consults, recreational therapy, pastoral care services and the Cancer Patient Support Program. Additionally, our oncology staff works with patients and families to identify support and resources in their home communities. Lymphomas, including Hodgkin’s Disease and the array of non-Hodgkin’s lymphomas, represent a growing area of clinical interest at the Comprehensive Cancer Center. Treatment ranges from standard “treatment guideline” protocols to local and national research trials investigating cutting edge therapies. One particular area of emphasis is dose-intensive therapy followed by either bone marrow or peripheral stem cell transplantation.   Hairy cell leukemia Bone marrow aspiration Auer rods Hairy cell leukemia - microscopic view Formed elements of blood   Enlarged spleen Definition: Hairy cell leukemia (HCL) is a rare cancer of the blood. It affects B cells, a type of white blood cell (lymphocyte). Alternative Names: Leukemic reticuloendotheliosis; HCL; Leukemia - hairy cell Causes, incidence, and risk factors: HCL is caused by the abnormal growth of B cells. The cells can look "hairy" under the microscope because they have fine projections coming from their surface. HCL can lead to low numbers of normal blood cells. The cause of this disease is unknown. It affects men more often than women. The average age of onset is 55. Hairy cell leukemia is rare. Symptoms: Easy bruising or bleeding Excessive sweating (especially at night) Fatigue Feeling full after eating only a small amount Recurrent infections and fevers Swollen lymph glands Weakness Weight loss Signs and tests: During a physical exam, the doctor may be able to feel a swollen spleen or liver. An abdominal CT scan may be done to confirm this swelling. A complete blood count shows low levels of white and red blood cells as well as platelets. Blood tests and a bone marrow biopsy can detect hairy cells. Flow cytometry or a test called TRAP can confirm the cancer diagnosis. Treatment: Treatment may not be needed for the early stages of this disease. Some patients may need an occasional blood transfusion. If treatment is needed because of very low blood counts, a variety of chemotherapy drugs can be used. A drug called interferon is also used. In most cases, chemotherapy can relieve the symptoms of the disease for many years. (When the signs and symptoms go away, you are said to be in remission.) Interferon can relieve symptoms but is unlikely to lead to remission. Removing the spleen may improve blood counts, but is unlikely to cure the disease. Antibiotics can be used to treat infections. People with low blood counts will receive growth factors and, possibly, transfusions. Expectations (prognosis): Newer chemotherapy treatments have greatly improved the survival of patients with hairy cell leukemia. Most patients with hairy cell leukemia can expect to live 10 years or longer with the disease. Complications: The low blood counts caused by hairy cell leukemia can lead to infections, fatigue, and excessive bleeding. Calling your health care provider: Call your health care provider if you have significant bleeding. Also call if you have signs of infection, such as a persistent fever, cough, or general ill feeling. Prevention: There is no known way to prevent this disease. References: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007: pp.1403-1404.

Review Date:7/11/2008 Reviewed By:David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and James R. Mason, MD, Oncologist, Director, Blood and Marrow Transplantation Program and Stem Cell Processing Lab, Scripps Clinic, Torrey Pines, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.