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Hairy cell leukemia

Contents of this page:

Illustrations

Bone marrow aspiration
Bone marrow aspiration
Auer rods
Auer rods
Hairy cell leukemia - microscopic view
Hairy cell leukemia - microscopic view
Formed elements of blood
Formed elements of blood
Enlarged spleen
Enlarged spleen

Alternative Names    Return to top

Leukemic reticuloendotheliosis; HCL; Leukemia - hairy cell

Definition    Return to top

Hairy cell leukemia (HCL) is a rare cancer of the blood. It affects B cells, a type of white blood cell (lymphocyte).

Causes    Return to top

HCL is caused by the abnormal growth of B cells. The cells can 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 onset is 55. Hairy cell leukemia is rare.

Symptoms    Return to top

Exams and Tests    Return to top

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

A complete blood count 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 TRAP can confirm the cancer diagnosis.

Treatment    Return to top

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 interferon is also used. In most cases, chemotherapy can relieve the symptoms of the disease 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.

Outlook (Prognosis)    Return to top

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 with the disease.

Possible Complications    Return to top

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

When to Contact a Medical Professional    Return to top

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.

Prevention    Return to top

There is no known way to prevent this disease.

References    Return to top

Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007: pp.1403-1404.

Update Date: 7/11/2008

Updated by: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and James R. Mason, MD, Oncologist, Director, Blood and Marrow Transplantation Program and Stem Cell Processing Lab, Scripps Clinic, Torrey Pines, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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