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Hairy cell leukemia


Table of Contents

OVERVIEW OF PDQ
What is PDQ?
How to use PDQ
DESCRIPTION
What is hairy cell leukemia?
STAGE EXPLANATION
Stages of hairy cell leukemia
Untreated hairy cell leukemia
Progressive hairy cell leukemia, post-splenectomy
Refractory hairy cell leukemia
TREATMENT OPTION OVERVIEW
How hairy cell leukemia is treated
Treatment by stage
UNTREATED HAIRY CELL LEUKEMIA
REFRACTORY HAIRY CELL LEUKEMIA
TO LEARN MORE

OVERVIEW OF PDQ


What is PDQ?

PDQ is a computer system that gives up-to-date information on cancer and its prevention, detection, treatment, and supportive care. It is a service of the National Cancer Institute (NCI) for people with cancer and their families and for doctors, nurses, and other health care professionals.

To ensure that it remains current, the information in PDQ is reviewed and updated each month by experts in the fields of cancer treatment, prevention, screening, and supportive care. PDQ also provides information about research on new treatments (clinical trials), doctors who treat cancer, and hospitals with cancer programs. The treatment information in this summary is based on information in the PDQ summary for health professionals on this cancer.


How to use PDQ

PDQ can be used to learn more about current treatment of different kinds of cancer. You may find it helpful to discuss this information with your doctor, who knows you and has the facts about your disease. PDQ can also provide the names of additional health care professionals who specialize in treating patients with cancer.

Before you start treatment, you also may want to think about taking part in a clinical trial. PDQ can be used to learn more about these trials. A clinical trial is a research study that attempts to improve current treatments or finds information on new treatments for patients with cancer. Clinical trials are based on past studies and information discovered in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help patients with cancer. Information is collected about new treatments, their risks, and how well they do or do not work. When clinical trials show that a new treatment is better than the treatment currently used as "standard" treatment, the new treatment may become the standard treatment. Listings of current clinical trials are available on PDQ. Many cancer doctors who take part in clinical trials are listed in PDQ.

To learn more about cancer and how it is treated, or to learn more about clinical trials for your kind of cancer, call the National Cancer Institute's Cancer Information Service. The number is 1-800-4-CANCER (1-800-422-6237); TTY at 1-800-332-8615. The call is free and a trained information specialist will be available to answer cancer-related questions.

PDQ is updated whenever there is new information. Check with the Cancer Information Service to be sure that you have the most up-to-date information.


DESCRIPTION


What is hairy cell leukemia?

Hairy cell leukemia is a disease in which cancer (malignant) cells are found in the blood and bone marrow. The disease is called hairy cell leukemia because the cancer cells look "hairy" when examined under a microscope.

Hairy cell leukemia affects white blood cells called lymphocytes. Lymphocytes are made in the bone marrow and other organs. The bone marrow is the spongy tissue inside the large bones in the body. The bone marrow makes red blood cells (which carry oxygen and other materials to all tissues of the body), white blood cells (which fight infection), and platelets (which make the blood clot). Lymphocytes also are made in the spleen (an organ in the upper abdomen that makes lymphocytes and filters old blood cells from the blood), the lymph nodes (small bean-shaped organs throughout the body), and other organs.

When hairy cell leukemia develops, the leukemia cells may collect in the spleen, and the spleen swells. There also may be too few normal white blood cells in the blood because the leukemia cells invade the bone marrow, and the marrow cannot produce enough normal white blood cells. This may result in an infection. A doctor should be seen if the following symptoms occur: constant tiredness, the spleen is larger than normal, or the development of an infection that won't go away.

If there are symptoms, a doctor will order blood tests to count the number of each of the different types of blood cells. If the results of the blood tests are not normal, more blood tests may have to be done. The doctor may also do a bone marrow biopsy. During this test, a needle is inserted into a bone and a small amount of bone marrow is taken out and looked at under the microscope. The doctor can then tell what kind of leukemia the patient has and plan the best treatment.

The chance of recovery (prognosis) depends on how many cancer cells are in the blood and bone marrow, and the patient's age and general health.

There are separate PDQ patient information summaries on acute lymphocytic leukemia (adult and childhood), acute myeloid leukemia (adult and childhood), chronic lymphocytic leukemia, and chronic myelogenous leukemia.


STAGE EXPLANATION


Stages of hairy cell leukemia

There is no staging system for hairy cell leukemia. Patients are grouped together based on whether they have been treated for their leukemia or not.


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 leukemia.


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.


TREATMENT OPTION OVERVIEW


How hairy cell leukemia is treated

Some people with hairy cell leukemia have few symptoms and may not need treatment right away. There are treatments for all patients with hairy cell leukemia that is causing symptoms. Three kinds of treatment are used:

Bone marrow transplants are being tested in clinical trials.

If the spleen is swollen, the doctor may take out the spleen in an operation called a splenectomy.

Chemotherapy uses drugs to kill cancer cells. Chemotherapy may be taken by pill, or it may be put into the body by a needle in the vein, muscle, or under the skin. Chemotherapy is called a systemic treatment because the drug enters the bloodstream, travels through the body, and can kill cancer cells throughout the body.

Biological therapy tries to get the body to fight the 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.

Bone marrow transplantation is used to replace the bone marrow with healthy bone marrow. First, all of the bone marrow in the body is destroyed with high doses of chemotherapy with or without radiation therapy. Healthy marrow is then taken from another person (a donor) whose tissue is the same as or almost the same as the patient's. The donor may be a twin (the best match), a brother or sister, or another unrelated person. The healthy marrow from the donor is given to the patient through a needle in the vein, and the marrow replaces the marrow that was destroyed. Bone marrow transplants using marrow from a relative or unrelated person is called an allogeneic bone marrow transplant.


Treatment by stage

Standard treatment may be considered because of its effectiveness in patients in past studies, or participation in a clinical trial may be considered. Not all patients are cured with standard therapy and some standard treatments may have more side effects than are desired. For these reasons, clinical trials are designed to find better ways to treat cancer patients and are based on the most up-to-date information. Clinical trials are ongoing in most parts of the country for patients with hairy cell leukemia. To learn more about clinical trials, call the Cancer Information Service at 1-800-4-CANCER (1-800-422-6237); TTY at 1-800-332-8615.


UNTREATED HAIRY CELL LEUKEMIA

Treatment may be one of the following:

1. If there are no symptoms, treatment may not be needed. The doctor will follow the patient closely so treatment can be started if the leukemia gets worse.

2. Biological therapy.

3. Chemotherapy.

4. Surgery to remove the spleen (splenectomy).


REFRACTORY HAIRY CELL LEUKEMIA

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.


TO LEARN MORE

TO LEARN MORE..... CALL 1-800-4-CANCER

To learn more about hairy cell leukemia, call the National Cancer Institute's Cancer Information Service at 1-800-4-CANCER (1-800-422-6237); TTY at 1-800-332-8615. By dialing this toll-free number, trained information specialists can answer your questions.

The Cancer Information Service also has booklets about cancer that are available to the public and can be sent on request. The following general booklets on questions related to cancer may be helpful:

What You Need To Know About Cancer
Taking Time: Support for People with Cancer and the People Who Care About
Them
What Are Clinical Trials All About?
Chemotherapy and You: A Guide to Self-Help During Treatment
Radiation Therapy and You: A Guide to Self-Help During Treatment
Eating Hints for Cancer Patients
Advanced Cancer: Living Each Day
When Cancer Recurs: Meeting the Challenge Again
Research Report: Bone Marrow Transplantation

There are many other places where people can get materials and information about cancer treatment and services. The social service office at a hospital can be checked for local and national agencies that help with getting information about finances, getting to and from treatment, getting care at home, and dealing with problems.

For more information from the National Cancer Institute, please write to this address:

National Cancer Institute
Office of Cancer Communications
31 Center Drive, MSC 2580
Bethesda, MD 20892-2580

Date Last Modified: 04/1999


If you want to know more about cancer and how it is treated, or if you wish to know about clinical trials for your type of cancer, you can call the NCI's Cancer Information Service at 1-800-422-6237, toll free. A trained information specialist can talk with you and answer your questions.


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