Our Treatment Approach to Hairy Cell Leukemia

Abstract

Tüylü Hücreli Lösemide Tedavi Yaklaşımımız

Abstract

Objectives: Hairy cell leukemia (HCL) is a rare chronic lymphoid malignancy which develops from mature B cells. The frequency is 2% of all leukemias and diagnosed mostly in middle ages. Patients respond to treatment with purine analogues. In this study, our aim is to present our HCL patients, their demographic features, treatmentmodalities and response to therapy. Materials and Methods: Thirty-eight HCL patients who were diagnosed and treated at our center between 1984 and 2019 were retrospectively evaluated. Ki-square test and student t-test were used in comparison. P<0.05 was considered statistically significant. Results: Median age of patients were 50 (range=31-79). The average leucocyte, hemoglobin, platelet, lactate dehydrogenase (LDH) levels and the spleen size at diagnosis were as follows: 5.1x109/L (range=1.5-20), 12.4 g/dL (range=9-17.5), 118x109/L (range=15-300), 179 IU (range=107-394), 155 mm (range=110-290). Eight patients (21%) underwent splenectomy prior to chemotherapy. All patients received cladribine (0.1 mg/kg, 7 days) as a first line treatment; eight patients (21%) had two courses for remission. Seven patients (18%) had a relapse and one patient received pentostatin (4 mg/m2, 1 dose every 2 weeks, 6 months). The median follow-up time was 95 months. Leucocyte, hemoglobin, platelet levels were lower, LDH levels were higher and spleen size was increased in patients with relapse however no statistical difference were detected. Conclusion: We detected 18% relapse rate in our series and all patients were followed in remission after second line purine analogue treatment. Generally, HCL is a chronic disease with a favorable prognosis.

Keywords

• Chronic Leukemia
• Hairy Cell Leukemia
• Purine Analogs
• Splenectomy

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