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Treatments and drugs
By Mayo Clinic staffTreatment isn't always necessary for people with hairy cell leukemia. Because this cancer progresses very slowly and sometimes doesn't progress at all, some people prefer to wait to treat their cancer only if it causes signs and symptoms. The majority of people with hairy cell leukemia eventually need treatment.
Though you may be eager to rid your body of cancer if you've been diagnosed with hairy cell leukemia, there's no advantage to early treatment. Unlike some other types of cancer, hairy cell leukemia is quite treatable at all stages, meaning that waiting to treat your cancer won't make remission any less likely.
If your hairy cell leukemia causes signs and symptoms, you may decide to undergo treatment. There is no cure for hairy cell leukemia. But treatments are effective at putting hairy cell leukemia in remission for years.
Chemotherapy
Doctors consider chemotherapy drugs the first line of treatment for hairy cell leukemia. The great majority of people will experience complete or partial remission through the use of chemotherapy. Two chemotherapy drugs are used in hairy cell leukemia:
- Cladribine (Leustatin). Treatment for hairy cell leukemia typically begins with cladribine. You receive a continuous infusion of the drug into a vein over several days. Most people who receive cladribine experience a complete remission that can last for several years. If your hairy cell leukemia returns, you can be treated with cladribine again. Side effects of cladribine may include infection and fever.
- Pentostatin (Nipent). Pentostatin causes remission rates similar to cladribine, but it's given on a different schedule. People who take pentostatin receive infusions every other week for three to six months. Side effects of pentostatin may include fever, nausea and infection.
Biological treatments
Biological therapy attempts to make cancer cells more recognizable to your immune system. Once your immune system identifies cancer cells as intruders, it can set about destroying your cancer. Two types of biological treatments are used in hairy cell leukemia:
- Interferon. You might receive interferon if chemotherapy hasn't been effective or if you can't take chemotherapy. Most people experience partial remission with interferon, which is taken for a year. Side effects include flu-like symptoms, such as fever and fatigue.
- Rituximab (Rituxan). Rituximab is a monoclonal antibody approved to treat non-Hodgkin lymphoma and chronic lymphocytic leukemia, though it's sometimes used in hairy cell leukemia. If chemotherapy drugs haven't worked for you or you can't take chemotherapy, your doctor might consider rituximab. Side effects of rituximab include fever and infection.
Surgery
Surgery to remove your spleen (splenectomy) might be an option if your spleen ruptures or if it's enlarged and causing pain. Though removing your spleen can't cure hairy cell leukemia, it can usually restore normal blood counts. Splenectomy isn't commonly used to treat hairy cell leukemia, but it may be helpful in certain situations. All surgery carries a risk of bleeding and infection.
- Abeloff MD. Abeloff's Clinical Oncology. 4th ed. Philadelphia, Pa.: Churchill Livingstone; 2008:2309.
- Hoffman R, et al. Hematology: Basic Principles and Practice. 5th ed. Philadelphia, Pa.: Churchill Livingstone Elsevier; 2009. http://www.mdconsult.com/books/about.do?about=true&eid=4-u1.0-B978-0-443-06715-0..X5001-8--TOP&isbn=978-0-443-06715-0&uniqId=230100505-56. Accessed Feb. 2, 2012.
- Lichtman MA, et al. Williams Hematology. 8th ed. New York, N.Y.: The McGraw-Hill Companies; 2010. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=69. Accessed Feb. 2, 2012.
- Hairy cell leukemia treatment (PDQ): Patient version. National Cancer Institute. http://www.cancer.gov/cancertopics/pdq/treatment/hairy-cell-leukemia/patient. Accessed Feb. 2, 2012.
- Grever MR, et al. Modern strategies for hairy cell leukemia. Journal of Clinical Oncology. 2011;29:583.
- Rituxan (prescribing information). South San Francisco, Calif.: Genentech Inc.; 2009. http://www.rituxan.com/index.html. Accessed Feb. 2, 2012.
- Integrative medicine & complementary and alternative therapies as part of blood cancer care. The Leukemia & Lymphoma Society. http://www.lls.org/#/resourcecenter/freeeducationmaterials/treatment/integrativemedandcam. Accessed Feb. 2, 2012.
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