Download PDF
CC BY-NC-ND 4.0 · Indian J Med Paediatr Oncol 2014; 35(04): 271-275
DOI: 10.4103/0971-5851.144988
ORIGINAL ARTICLE

Hairy cell leukemia: A decade long experience of North Indian Hematology Center

Venkatesan Somasundaram
Department of Hematology, All India Institute of Medical Sciences, New Delhi, India
,
Abhishek Purohit
Department of Hematology, All India Institute of Medical Sciences, New Delhi, India
,
Mukul Aggarwal
Department of Hematology, All India Institute of Medical Sciences, New Delhi, India
,
Prabhu Manivannan
Department of Hematology, All India Institute of Medical Sciences, New Delhi, India
,
Pravas Mishra
Department of Hematology, All India Institute of Medical Sciences, New Delhi, India
,
Tulika Seth
Department of Hematology, All India Institute of Medical Sciences, New Delhi, India
,
Seema Tyagi
Department of Hematology, All India Institute of Medical Sciences, New Delhi, India
,
Manoranjan Mahapatra
Department of Hematology, All India Institute of Medical Sciences, New Delhi, India
,
Hara P. Pati
Department of Hematology, All India Institute of Medical Sciences, New Delhi, India
,
Renu Saxena
Department of Hematology, All India Institute of Medical Sciences, New Delhi, India
› Author Affiliations
› Further Information
Also available at
  PDF Download Permissions and Reprints

Abstract

Introduction: Hairy cell leukemia is a rare chronic B-cell disorder that follows an indolent but progressive course. This disorder is characterized by pancytopenia, splenomegaly, bone marrow fibrosis and the presence of atypical lymphoid cells with hairy projections in peripheral blood, bone marrow and spleen. Treatment is mainly with nucleoside analog cladribine, which induces complete remission in up to 85% cases. Materials and Methods: This is a retrospective analysis of Hairy cell Leukemia cases diagnosed and treated in the Department of Hematology, All India Institute of Medical Sciences, New Delhi between 2002 and 2013. Various parameters such as clinical features, laboratory parameters including complete blood cell count, bone marrow findings, cytochemistry, immunophenotyping by flowcytometry or immunohistochemistry, treatment protocol and complications secondary to treatment and relapse were reviewed. Results: A total of 35 cases were diagnosed during this period of 12 years of which 27 received cladribine and went in to remission. Median follow-up duration was 26 months. 5 (18%) cases had a relapse and all relapsed cases achieved second remission with cladribine; however, there was no case of second malignancy in our cohort. Conclusion: Cladribine has emerged as the treatment of choice for hairy cell leukemia given that the overwhelming majority of patients achieve long-lasting complete remissions. Upon relapse, these patients could be successfully salvaged with cladribine retreatment.

Keywords

Cladribine - Hairy cell leukemia - relapse - remission


Publication History

Article published online:
19 July 2021

© 2014. Indian Society of Medical and Paediatric Oncology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/.)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 

  • References

  • 1 Goodman GR, Bethel KJ, Saven A. Hairy cell leukemia: An update. Curr Opin Hematol 2003;10:258-66.
  • 2 Malfuson JV, Gisserot O, Cremades S, Doghmi K, Fagot T, Souleau B, et al. Hairy-cell leukemia: 30 cases and a review of the literature. Ann Med Interne (Paris) 2003;154:435-40.
  • 3 Bouroncle BA, Wiseman BK, Doan CA. Leukemic reticuloendotheliosis. Blood 1958;13:609-30.
  • 4 Cheson BD, Sorensen JM, Vena DA, Montello MJ, Barrett JA, Damasio E, et al. Treatment of hairy cell leukemia with 2-chlorodeoxyadenosine via the group C protocol mechanism of the national cancer institute: A report of 979 patients. J Clin Oncol 1998;16:3007-15.
  • 5 Johnston JB, Grever MR. Hairy cell leukemia. In: Greer JP, List AF, editors. Wintrobe′s Clinical Hematology. 13 th ed. Philadelphia: Lippincott Williams & Wilkins; 2014. p. 1929-50.
  • 6 Gaman AM. Hairy cell leukemia - a rare type of leukemia. A retrospective study on 39 patients. Rom J Morphol Embryol 2013;54:575-9.
  • 7 Saven A, Burian C, Koziol JA, Piro LD. Long-term follow-up of patients with hairy cell leukemia after cladribine treatment. Blood 1998;92:1918-26.
  • 8 Hoffman MA. Clinical presentations and complications of hairy cell leukemia. Hematol Oncol Clin North Am 2006;20: 1065-73.
  • 9 Galani KS, Subramanian PG, Gadage VS, Rahman K, Ashok Kumar MS, Shinde S, et al. Clinico-pathological profile of hairy cell leukemia: Critical insights gained at a tertiary care cancer hospital. Indian J Pathol Microbiol 2012;55:61-5.
  • 10 Golomb HM, Catovsky D, Golde DW. Hairy cell leukemia: A clinical review based on 71 cases. Ann Intern Med 1978;89:677-83.
  • 11 Burke JS, Byrne GE Jr, Rappaport H. Hairy cell leukemia (leukemic reticuloendotheliosis). I. A clinical pathologic study of 21 patients. Cancer 1974;33:1399-410.
  • 12 Allsup DJ, Cawley JC. The diagnosis and treatment of hairy-cell leukaemia. Blood Rev 2002;16:255-62.
  • 13 Jehn U, Bartl R, Dietzfelbinger H, Haferlach T, Heinemann V. An update: 12-year follow-up of patients with hairy cell leukemia following treatment with 2-chlorodeoxyadenosine. Leukemia 2004;18:1476-81.
  • 14 Tallman MS. Current treatment strategies for patients with hairy cell leukemia. Rev Clin Exp Hematol 2002;6:389-400.
  • 15 Chen YH, Tallman MS, Goolsby C, Peterson L. Immunophenotypic variations in hairy cell leukemia. Am J Clin Pathol 2006;125:251-9.
  • 16 Jasionowski TM, Hartung L, Greenwood JH, Perkins SL, Bahler DW. Analysis of CD10+ hairy cell leukemia. Am J Clin Pathol 2003;120:228-35.
  • 17 National Comprehensive Cancer Network. Non Hodgkin′s Lymphoma Version 3; 2014. Available from: http://www.nccn.org/professionals/physician_gls/pdf/nhl.pdf. [Last accessed on 2014 Aug 18].
  • 18 Goodman GR, Burian C, Koziol JA, Saven A. Extended follow-up of patients with hairy cell leukemia after treatment with cladribine. J Clin Oncol 2003;21:891-6.
  • 19 Estey EH, Kurzrock R, Kantarjian HM, O′Brien SM, McCredie KB, Beran M, et al. Treatment of hairy cell leukemia with 2-chlorodeoxyadenosine (2-CdA). Blood 1992;79:882-7.
  • 20 Juliusson G, Liliemark J. Rapid recovery from cytopenia in hairy cell leukemia after treatment with 2-chloro- 2′-deoxyadenosine (CdA): Relation to opportunistic infections. Blood 1992;79:888-94.
  • 21 Seymour JF, Kurzrock R, Freireich EJ, Estey EH 2-chlorodeoxyadenosine induces durable remissions and prolonged suppression of CD4+ lymphocyte counts in patients with hairy cell leukemia. Blood 1994;83:2906-11.
  • 22 Zinzani PL, Tani M, Marchi E, Stefoni V, Alinari L, Musuraca G, et al. Long-term follow-up of front-line treatment of hairy cell leukemia with 2-chlorodeoxyadenosine. Haematologica 2004;89:309-13.
  • 23 Tiacci E, Trifonov V, Schiavoni G, Holmes A, Kern W, Martelli MP, et al. BRAF mutations in hairy-cell leukemia. N Engl J Med 2011;364:2305-15.
  • 24 Samuel J, Macip S, Dyer MJ. Efficacy of vemurafenib in hairy-cell leukemia. N Engl J Med 2014;370:286-8.
  • 25 Dietrich S, Hüllein J, Hundemer M, Lehners N, Jethwa A, Capper D, et al. Continued response off treatment after BRAF inhibition in refractory hairy cell leukemia. J Clin Oncol 2013;31:e300-3.