Sandbox: HCL therapy

Medical Therapy

• Indications to initiate medical therapy among patients with hairy cell leukemia include:

• The presence of systemic symptoms such as fever, night sweats, and significant weight loss
• The presence of subcostal abdominal discomfort due splenic distension
• Positive history of recurrent infections.
• Hemoglobin concentration lower than 12 g/dl
• Platelets count lower than 100,000/mcl
• Absolute neutrophil count lower than 1000/mcl

• Pharmacological agents used for the treatment of hairy cell leukemia patients include:

• Cladribine
• Pentostatin
• Rituximab
• Interferon alpha
• Vemurafenib

Patients presenting with thrombocytopenia or anemia due to bone marrow failure Patients presenting with refractory autoimmune hemolytic anemia or refractory autoimmune thrombocytopenia Evidence of symptomatic splenomegaly, with the spleen being palpated more than 6cm below the costal margin Evidence of symptomatic progressive lymph nodes swelling, with a size greater than 10 cm in diameter Evidence of a rapidly progressive lymphocytosis, which might be observed as:

An increase of greater than 50% over a 2-month period A lymphocyte doubling period shorter than six months