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Treatment of Hairy Cell Leukemia: Overview and First-Line Options

Published: Monday, Jul 08, 2019
 Hairy cell leukemia (HCL) is a rare malignancy for which treatment has progressed significantly in recent years. Patients with HCL were once limited to survival times of approximately 4 years following diagnosis, but current and developing treatments are allowing these patients to lead normal lives with life expectancies that are similar to those of the general population.1,2  This article provides a historical overview of treatment options that have been effective in combating HCL, and it discusses the progression that culminated in the current and emerging first-line HCL therapies.

Historical Perspective and Treatment Options

HCL was first recognized as a clinical entity in a 1958 paper describing a series of patients with leukemic reticuloendotheliosis.3 In this report, nearly every patient presented with an enlarged spleen, and the authors detailed the cytoplasmic projections of the characteristic “hairy” cells that were detected in blood samples.3 In this era, patients often died of infectious complications and cytopenia.1

Hairy cells typically infiltrate the bone marrow and spleen; these sites are frequently symptomatic in patients with HCL. Splenomegaly is historically a common presenting feature of HCL; however, modern early detection abilities may be causing this statistic to decline.4 The bone marrow of these patients is typically difficult to aspirate, frequently resulting in a dry tap.4 Patients with HCL also often develop opportunistic infections.5

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