Retrospective evaluation of patients with hairy cell leukemia: Single center experience

Objective: Hairy cell leukemia (HCL) is a rare chronic lymphoproliferative disease which is characterized by circulating B lymphocytes with prominent cytoplasmic projections. Treatment of patients with HCL has changed rapidly during the last 40 years by the introduction of the purine analogs into clinical setting. Splenectomy was the first effective treatment modality increasing the survival. Recently, given the effectiveness of the purine analogs, as well as the ease of administration, other therapies have been abandoned. The aim of this study is to retrospectively evaluate the patients with HCL treated and followed-up in our Center. Method: We retrospectively evaluated 15 patients (14 male, 1 female)who were diagnosed, treated and followed-up in our centerbetween 1992 and 2004. Median age was 50 (28-79) years and median symptom duration was 11.5 months (2-48). Median follow up duration was 48 months (9-148). The most prominent symptoms were as follows; weakness (60%), fever (20%), night sweatening (20%), fatigue (20%). Splenomegaly was found in 14 (93%) of the patients while hepatomegaly was seen only in 3 patients. Pancytopenia was determined in all patients. Peripheral blood smear, bone marrow aspiration and biopsy were applied to all patients. TRAP test was evaluated in 10 patients and was positive in 9 of them. Results: Four patients were treated with interferon alpha only, 1 patient was treated with splenectomy, 3 patients were treated with interferon alpha+cladribine and 6 patients were treated with only cladribine. Splenic radiotherapy was given to only 1 patient. Pancytopenia disappeared after treatment in 13 patients. Relapse was detected in 3 patients after interferon use and all these patients were treated with cladribine. Spleen size reduced to normal size in 13 patients after therapy. All patients are still alive under regular follow up. Conclusion: Cladribine was found to be effective treatment modality in HCL patients either in first line setting or in relapsed patients. It also provides long term survival for our patients. © Hellenic Society of Haematology.