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  Hairy cell leukemia

Hairy cell leukemia is a cancer of the blood. In hairy cell leukemia bone marrow produces too many lymphocytes, a white blood cell. This disease is rare and has a slow progression. The name hairy cells is derived from the abnormal villi – fine projections from the surface of the lymphocytes. When the cells increase, the levels of healthy white blood cells, red blood cells and platelets is decreased.

Hairy cell leukemia
Hairy cell leukemia

Hairy cell leukemia is classified as a chronic cancer because treatment can result in long term remission. Hairy cell leukemia may not disappear from the body completely. Six hundred appear in the United State per year. This disease affects men more than women and it is not seen in teenagers or young children. Patients with hairy cell leukemia have an great chance of living cancer-free, after treatment for at least ten years.


Some patients, who are diagnosed, receive their diagnosis inadvertently for a routine blood test, in which the hairy cells are detected. These patients are usually symptom less. Symptoms that do appear are a full feeling in the stomach that makes patients unable to eat more than a small amount per meal, tiredness, unusual and easy bruising, an enlarged spleen, infections, muscle weakness and loss of weight.


When hairy cell leukemia is suspected, a doctor will order blood tests to check for a low blood count of all types of blood cells and the presence of hairy white blood cells – the markers of this disease.

A physical exam will check for an enlarged spleen and swollen lymph nodes which can indicate a presence of leukemia.

A bone marrow biopsy is another test performed when checking for blood cancers. A bone marrow biopsy is performed by aspiration with a small needle or a traditional biopsy with a larger need to remove marrow and a small piece of bone. The marrow is microscopically evaluated for the quantity and quality of cells.

A CT scan of the body may be prescribed to determine the condition of the spleen and the lymph nodes.


Most patients with hairy cell leukemia will not require immediate treatment, because this blood cancer has a slow progression rate. Sometimes the blood cancer does not progress at all. Patients may only choose treatment if symptoms appear that negatively impact quality of life. Eventually, most people will hairy cell leukemia will require treatment.

Treatment for hairy cell leukemia is dependent on these factors: the count or level of cells that are hairy cells in relationship the healthy blood cells in the bone marrow and blood, recurrence of the leukemia, severity of symptoms, such as infection due to the leukemia, and whether the spleen is swollen.

The chance of recovery or prognosis of treatment for hairy cell leukemia is dependent on the growth rate of the hairy cell leukemia cells in the blood stream and how the patient responds to treatment options. Most treatment outcomes are a long lasting remission – (signs and symptoms are not present). If the leukemia symptoms return a second treatment often results in another remission for patients.

When treatment is begun there are a few options. Originally a splenectomy (the surgical removal of the spleen) was a option for treatment – but it is hardly ever done currently. If the spleen is damaged, causing pain or ruptures – surgery is required.

Chemotherapy is the first stage of treatment- resulting in a complete or partial remission in up to ninety percent of patients with hairy cell leukemia. Two drugs commonly used in chemotherapy are cladribine and pentostatin. Ten percent of patients do not achieve remission with these drugs.

Biological treatments are immunotherapies which are designed to make cancer cells more obvious to the patients’ natural immune system. The drugs used for biological therapy are interferon alpha and rituximab. Side effects may include bleeding, tiredness, headache and secondary infections.

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