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What Is Hairy Cell Leukemia? | Symptoms | Stages and Treatments | Clinical Trials | Greenebaum Cancer Center
Get answers to your Myelodysplastic Syndromes questions.
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There is no staging for hairy cell leukemia. The choice of treatment is based on whether and how the disease has been treated and its progress since treatment.
Untreated Hairy Cell Leukemia: No treatment has been given for the leukemia. Treatment may have been given for infections or other side effects of the disease. New treatment may be one of the following:
Progressive Hairy Cell Leukemia, Post-Splenectomy: Surgery has been done to remove the spleen (splenectomy), but the leukemia is getting worse.
Refractory Hairy Cell Leukemia: The leukemia has been treated but no longer responds to the treatment. If the patient has not responded to biological therapy, chemotherapy may be given. The patient may also wish to take part in a clinical trial of new chemotherapy drugs.
There are three primary treatments for patients with hairy cell leukemia:
Stem cell transplantation is being tested in clinical trials.
Side effects can occur with cancer treatments because healthy cells are often damaged along with cancer cells. The type and extent of these side effects vary depending on the particular treatment involved, its duration, and its dose.
If the spleen is swollen, the doctor may take out the spleen in an operation called a splenectomy.
Chemotherapy is the use of drugs to kill cancer cells. Some anticancer drugs are injected into a vein (IV) or a muscle; some are given by mouth; some are injected into the skin. Chemotherapy is a systemic treatment, meaning that the drugs flow through the bloodstream to nearly every part of the body to kill cancerous cells. Chemotherapy is generally given in cycles; a treatment period is followed by a recovery period, then another treatment period, and so on.
Chemotherapy drugs generally target rapidly dividing cancer cells. However, other cells that also divide rapidly include blood cells, cells that line the digestive tract, and cells in hair follicles. Unfortunately, these healthy cells may also be impacted by the chemotherapy drugs, resulting in side effects such as infections, tiredness, temporary hair loss, mouth sores and other symptoms. Not all chemotherapy patients develop all of these symptoms, and they usually go away during the recovery period or after treatment stops. Medicines and other treatments are available to control or minimize many of these symptoms.
Biological therapy tries to get the body to fight cancer. It uses materials made by the body or made in a laboratory to boost, direct, or restore the body's natural defenses against disease. Biological therapy is sometimes called biological response modifier (BRM) therapy or immunotherapy. Interferon, a substance made by the body to fight off foreign materials, is often used to treat hairy cell leukemia.
Stem cell transplantation is a treatment in which a patient's diseased bone marrow is replaced with healthy stem cells to repopulate the marrow.
Allogeneic transplant: A transplant using marrow from a relative or person not related to the patient is called an allogeneic transplant. Allogeneic transplants may be done using either a standard high-dose therapy or a less toxic, nonablative, immunosuppressive therapy.
In the standard high-dose therapy approach, all of the bone marrow in the body is destroyed with high doses of chemotherapy with or without radiation therapy. Healthy marrow or blood stem cells are then taken from another person (a donor) whose tissue is the same or almost the same as that of the patient. The donor may be a twin (the best match), a brother or sister, or a person who is not related. The healthy stem cells from the donor are then transferred to the patient through a needle in the vein, and the new marrow replaces the original marrow that was destroyed.
In a nonmyeloablative transplant, the goal is not to destroy the patient's marrow but to allow for the donor cells to take hold or "engraft." In this type of transplant, less intensive medications are used and the marrow is not completely destroyed prior to the transplant.
Autologous transplant: Another type of bone marrow transplant, called an autologous bone marrow transplant, is being studied in clinical trials. In this type of transplant, blood stem cells are taken from the patient after treatment with drugs to kill cancer cells. The stem cells that were taken from the patient are then frozen and stored. Next, high-dose chemotherapy is given to the patient with or without radiation therapy to destroy the remaining leukemia cells. The frozen stem cells are then thawed and given back to the patient through a needle in a vein to repopulate the marrow and make blood cells.
A greater chance for recovery occurs in hospitals that do more than five stem cell transplantations a year.
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