Hairy cell leukemia is a type of blood cancer that occurs when the bone marrow makes too many white blood cells called lymphocytes. Although hairy cell leukemia typically progresses very slowly, it can eventually lead to serious problems such as anemia, bleeding, infection and spleen enlargement. Treatments for the disease usually include chemotherapy, immunotherapy and, if necessary, surgery.
Watchful Waiting
According to the Cleveland Clinic, hairy cell leukemia may progress very slowly or, in some cases, not at all. Before undergoing extensive treatment, your doctor may advise that you carefully monitor the development of the disease over time.
Chemotherapy
Chemotherapy is considered the first-line treatment for hairy cell leukemia, according to the Mayo Clinic. Pentostatin is a chemotherapy drug delivered intravenously once every other week for approximately 3 to 6 months. According to the National Cancer Institute, two clinical trials have shown that, among patients who were treated with pentostatin and went into remission, between 56 and 67 percent remain relapse-free a median of 9 years after treatment.
Cladribine is another chemotherapy drug used for short-course treatment. It may be given intravenously by continuous infusion or over a period of 5 to 7 days in 2-hour sessions. Alternatively, it may be delivered beneath the skin by injection. According to the National Cancer Institute, treatment with cladribine typically results in complete remission rates of at least 50 percent, and patients who relapse can be retreated. Caldribine can suppress the immune system and cause infection, and its association with the development of secondary cancers is currently considered controversial.
The Cleveland Clinic notes that chemotherapy can increase your risk of developing other cancers like Hodgkin and non-Hodgkin lymphoma, so you should weigh the risks and benefits carefully with your doctor.
Immunotherapy
Immunotherapy is a type of biological treatment that attempts to enhance the body's immune system and its ability to fight off cancer. Interferon alpha is a commonly used biologic agent that is injected under the skin 3 times per week for 1 year, according to the National Cancer Institute. Research shows that interferon alpha does not produce the rates of sustained remission that chemotherapy with pentostatin achieves, so this type of immunotherapy is often reserved for those who are unable to take chemotherapy, or those for whom chemotherapy has failed, according to the Mayo Clinic.
Rituximab is another biologic antibody sometimes used to treat hairy cell leukemia in patients who have relapsed or failed to respond to other treatments.
Surgery
Hairy cell leukemia can cause the spleen to become enlarged and painful. Patients with swollen spleens that are in danger of rupturing may undergo a splenectomy--surgical treatment to remove the spleen. The Mayo Clinic points out that removing the spleen does not cure hairy cell leukemia; however, it can return the body's blood counts to normal.
