Hairy cell leukemia (patient information)

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Overview
Hairy cell leukemia (HCL) is one type of B-cell lymphoma. It is a rare disease, about 1,000 people in the United States are diagnosed each year. Patients with Hairy cell leukemia tend to be older in general. The cells are small B lymphocytes with projections coming off them that give them a "hairy" appearance. They are always found in the bone marrow, spleen and circulating in the blood. Usual symptoms include unexplained weight loss, fever, night sweat and so on. Like other Non-Hodgkin lymphoma, biospy may be the best method for diagnosis. For Hairy cell leukemia is slow-growing, some patients may never need treatment. An enlarging spleen or dropping blood counts are the usual reasons to begin treatment. Treatments include radiation therapy, chemotherapy, bone marrow or peripheral blood stem cell transplantation and a combination of them.

What are the symptoms of Hairy cell leukemia?

 * 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

What causes Hairy cell leukemia?

 * HCL is caused by the abnormal growth of B cells. The cells 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 diagnosis is 55.

Diagnosis

 * During a physical exam, the doctor may be able to feel a swollen spleen or liver. An abdominal CT scan may be done to evaluate this swelling.


 * A complete blood count usually 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 tartrate resistant acid phosphatase (TRAP) can confirm the cancer diagnosis.

When to seek urgent medical care

 * 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.

Treatment options

 * 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 cladribine is used. In most cases, chemotherapy can relieve the symptoms 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.

Where to find medical care for Hairy cell leukemia?
Directions to Hospitals Treating Hairy cell leukemia

Prevention of Hairy cell leukemia
There is no known way to prevent this disease.

What to expect (Outlook/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 after diagnosis.

Possible complications
The low blood counts caused by hairy cell leukemia can lead to infections, fatigue, and excessive bleeding.

==Related chapters=
 * B cell lymphoma