What is Hairy Cell Leukemia? Hairy cell leukemia is a rare cancer of the bone marrow and blood. It is a type of hematological malignancy that is uncommon and is characterized by the buildup of abnormal B lymphocytes (a type of white blood cell). This disease is referred to as hairy cell leukemia because the cells appear “hairy” when seen under a microscope. In this article, we will explain the hairy cell leukemia prognosis, causes, symptoms, and treatment.
HCL (Hairy Cell Leukemia) was previously expressed as histiocytic leukemia, malignant reticulosis, or lymphoid myelofibrosis during the 1920s. In 1958, Bertha Bouroncle and her colleagues at The Ohio State University College of Medicine named the disease leukemic reticuloendotheliosis and significantly described it.
Causes of Hairy Cell Leukemia
In general, the cause of this disease is unknown, but there are certain risk factors and these are gender and age. It affects men more than women and as the individual ages, they become more prone to this disease. The average age that it is diagnosed is 55.
Hairy Cell Leukemia Symptoms
The following are signs and symptoms which could indicate a possible Hairy Cell Leukemia prognosis:
- Weakness
- Fatigue
- Recurrent infections or fever
- Unexplained weight loss
- Excessive sweating; night sweats
- Easy bruising or bleeding
- Swollen lymph nodes commonly in the underarm, neck, or groin
- Shortness of breath
- Bloated feeling even after eating only a small amount
There are other conditions that may also cause the same symptoms. Therefore, medical consultation is necessary if any of this occurs.
Hairy Cell Leukemia Diagnostics
The following procedures and lab tests may be done:
Physical Exam
The doctor checks for the general status of health and checks for the signs and symptoms of Hairy Cell Leukemia Prognosis such as weakness, fatigue, swollen nodes, easy bruising, and others. Also, a patient’s health history will be taken including past and present illnesses, health habits and other medically relevant history will be taken.
Enlarged liver or spleen may be felt during the physical exam and an abdominal CT scan may be done to confirm the swelling.
Complete Blood Count (CBC)
CBC checks for the number of red blood cells, white blood cells, and platelets and also the amount of hemoglobin present in the red blood cells.
Peripheral blood smear
This procedure is done as a follow-up test to abnormal results of a CBC and is a definite procedure in evaluating and identifying abnormal and immature blood cells. This confirms the “hairy” characteristic of the cells as well as the abnormalities in the numbers and shapes of the blood cells.
Bone marrow aspiration including biopsy
Bone marrow and blood are aspirated by inserting a hollow needle inside the hipbone or breastbone and afterward, the specimens are checked for cancer signs.
Immunophenotyping
A blood or bone marrow specimen is placed and viewed under a microscope to verify a certain pattern of proteins on the cell surface. The hairy cells have a distinct pattern.
CT (Computed Tomography) Scan
It can be a regular CT scan or a CT scan with contrast. It is a procedure that shows comprehensive pictures of different areas of the body from various angles. In a CT scan with contrast, a dye is injected into a vein, swallowed, or placed into a part of the body to show a more clear image of the area. Swollen spleen or liver could be seen in an abdominal CT scan.
Hairy Cell Leukemia Prognosis and Treatment
There is a variety of treatments available for patients with hairy cell leukemia and it could be standard treatment or clinical trials. Clinical trials are for improvements and better prognosis of patients with cancer. However, some clinical trials are open only to those patients that have not been treated using standard treatment. During the early stages of the disease, treatment may not be necessary although some patients occasionally need a blood transfusion. Close monitoring of patients is necessary to assess what kind of treatments are needed.
An array of chemotherapeutic drugs can be used for treating very low blood counts and a drug called cladribine may also be used. Generally, chemotherapy can be used to lessen the symptoms of the disease for a long period of time. (In the absence of signs and symptoms, remission is most likely. However, the drug cladribine only relieves the symptoms, but does not lead to remission).
A surgery, splenectomy (removal of the spleen) may be done in order to improve blood counts, but it is not a treatment. Antibiotics may also be used to treat underlying infections. Moreover, transfusions and giving growth factors are done for people with low blood counts.
Biologic therapy is a treatment for cancer that involves using the patient’s immune system in fighting off cancer. Substances are used to boost or restore the previously damaged immune system, these substances can either be synthetic or natural. Biotherapy or immunotherapy is the term for this kind of treatment. Interferon alfa, a biologic agent, is frequently used for hairy cell leukemia treatment. While Rituximab is used for relapsed or refractory patients.
As such, new types of treatment are being tested in clinical trials. A stem cell transplant is a method to restore the body’s blood cells destroyed by cancer and lost during chemotherapy. The stem cells are removed from donors, usually a blood relative, and then stored for infusion at a later time.
Repetitions of the previously completed diagnostic tests for cancer may be done to see the improvement or if the treatment is working. Decisions are made on whether the treatment will remain unchanged, alter, or stop altogether as a result of the re-testing and oftentimes called re-staging.
Hairy Cell Leukemia Treatment
Treatment options depend on the following:
- Number of hairy cells and healthy blood cells that are available in the bone marrow and blood
- If the spleen is swollen
- If symptoms of leukemia are present; infection
- If there are recurrences of leukemia after a preceding treatment
The Hairy Cell Leukemia Prognosis depends on the following:
Treatment is not needed if the disease is stagnant or in a slow phase If the disease is responsive to treatment
Usually, the treatment causes remission and if leukemia occurs again after a remission, then retreatment may cause another remission
Hairy Cell Leukemia Prognosis and Survival Rate
Chemotherapeutic treatments have significantly progressed throughout time and certain developments improve the survival of hairy cell leukemia patients.
It is important to contact your healthcare provider in times of excessive bleeding and signs of infections such as persistent fever, cough, or general ill feeling.
Complications of Hairy Cell Leukemia
- Infections
- fatigue and
- excessive bleeding is a possible complication of low blood counts caused by hairy cell leukemia.
Life Expectancy of Hairy Cell Leukemia
10 more years of life or longer can be expected for most patients subsequent to the diagnosis of hairy cell leukemia.
Prevention from Hairy Cell Leukemia
There is no known method for the prevention of this disease.
