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Information from PDQ for Patients
Hairy cell leukemia
208/01651
** 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.
(Refer to the PDQ summaries on Adult Acute Lymphoblastic Leukemia Treatment;
Childhood Acute Lymphoblastic Leukemia Treatment; Adult Acute Myeloid Leukemia
Treatment; Childhood Acute Myeloid Leukemia Treatment; Chronic Lymphocytic
Leukemia Treatment; and Chronic Myelogenous Leukemia Treatment for more
information.)
** STAGE EXPLANATION **
-- Stages of hairy cell leukemia --
There is no staging system for hairy cell leukemia. Patients are grouped
together based on whether or not they have been treated for their leukemia.
-- 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 --
Splenectomy (surgery to remove the spleen) has been done or systemic therapy
(treatment that uses substances that travel through the bloodstream, reaching
and affecting cells all over the body) has been given, 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:
- surgery
- chemotherapy (using drugs to kill cancer cells)
- biological therapy (using the body's immune system to fight cancer)
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 **
Call
For more information, U.S. residents may call the National Cancer Institute's
(NCI's) Cancer Information Service toll-free at 1-800-4-CANCER (1-800-422-6237)
Monday through Friday from 9:00 a.m. to 4:30 p.m. Deaf and hard-of-hearing
callers with TTY equipment may call 1-800-332-8615. The call is free and a
trained Cancer Information Specialist is available to answer your questions.
Web sites and Organizations
The NCI's Cancer.gov Web site (http://cancer.gov) provides online access to
information on cancer, clinical trials, and other Web sites and organizations
that offer support and resources for cancer patients and their families. There
are also many other places where people can get materials and information about
cancer treatment and services. Local hospitals may have information on local
and regional agencies that offer information about finances, getting to and
from treatment, receiving care at home, and dealing with problems associated
with cancer treatment.
Publications
The NCI has booklets and other materials for patients, health professionals,
and the public. These publications discuss types of cancer, methods of cancer
treatment, coping with cancer, and clinical trials. Some publications provide
information on tests for cancer, cancer causes and prevention, cancer
statistics, and NCI research activities. NCI materials on these and other
topics may be ordered online or printed directly from the NCI Publications
Locator (https://cissecure.nci.nih.gov/ncipubs). These materials can also be
ordered by telephone from the Cancer Information Service toll-free at
1-800-4-CANCER (1-800-422-6237), TTY at 1-800-332-8615.
LiveHelp
The NCI's LiveHelp service, a program available on several of the Institute's
Web sites, provides Internet users with the ability to chat online with an
Information Specialist. The service is available from 9:00 a.m. to 10:00 p.m.
Eastern time, Monday through Friday. Information Specialists can help Internet
users find information on NCI Web sites and answer questions about cancer.
Write
For more information from the NCI, please write to this address:
National Cancer Institute
Office of Communications
31 Center Drive, MSC 2580
Bethesda, MD 20892-2580
** ABOUT PDQ **
PDQ is a comprehensive cancer database available on Cancer.gov.
PDQ is the National Cancer Institute's (NCI's) comprehensive cancer information
database. Most of the information contained in PDQ is available online at
Cancer.gov (http://cancer.gov), the NCI's Web site. PDQ is provided as a
service of the NCI. The NCI is part of the National Institutes of Health, the
federal government's focal point for biomedical research.
PDQ contains cancer information summaries.
The PDQ database contains summaries of the latest published information on
cancer prevention, detection, genetics, treatment, supportive care, and
complementary and alternative medicine. Most summaries are available in two
versions. The health professional versions provide detailed information
written in technical language. The patient versions are written in
easy-to-understand, non-technical language. Both versions provide current and
accurate cancer information.
The PDQ cancer information summaries are developed by cancer experts and
reviewed regularly.
Editorial Boards made up of experts in oncology and related specialties are
responsible for writing and maintaining the cancer information summaries. The
summaries are reviewed regularly and changes are made as new information
becomes available. The date on each summary ("Date Last Modified") indicates
the time of the most recent change.
PDQ also contains information on clinical trials.
Before starting treatment, patients may want to think about taking part in a
clinical trial. A clinical trial is a study to answer a scientific question,
such as whether one treatment is better than another. Trials are based on past
studies and what has been learned in the laboratory. Each trial answers
certain scientific questions in order to find new and better ways to help
cancer patients. During treatment clinical trials, information is collected
about new treatments, the risks involved, and how well they do or do not work.
If a clinical trial shows that a new treatment is better than one currently
being used, the new treatment may become "standard."
Listings of clinical trials are included in PDQ and are available online at
Cancer.gov (http://cancer.gov/clinical_trials). Descriptions of the trials are
available in health professional and patient versions. Many cancer doctors who
take part in clinical trials are also listed in PDQ. For more information,
call the Cancer Information Service 1-800-4-CANCER (1-800-422-6237); TTY at
1-800-332-8615.
Date Last Modified: 09/2002
******************************************************************************
* If you want to know more about cancer and how it is treated, or if you *
* 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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This information has been brought to you by
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