Alternate Names: Leukemic reticuloendotheliosis; HCL

Causes and Risks:

Hairy cell leukemia (HCL) is characterized by a reduction in all types of blood cells: white blood cells, red blood cells, and platelets. Characteristic hairy cells are seen in the peripheral blood and bone marrow.HCL cells have fine projections from their surface that creates an impression of the cells appearing"hairy." Liver and spleen enlargement is common.

People affected with this leukemia have an increased risk of acquiring infections because of the body’s lowered resistance to infection. Bleeding tendencies are also increased because of the low platelet count. The cause of this disease is unknown. It affects men 5 times more often than women, and the median age of onset is 55. Other risk factors are unknown. The incidenceofhairy cell leukemia is estimated to account for about 2% of leukemias each year.

Prevention: There is no known prevention.

Symptoms:

• Weakness
• Fatigue
• Easy bruising or bleeding
• Recurrent infection
• Sweating, excessive
• Swollen lymph glands
• Night sweats

Signs and Tests: A physical examination reveals enlarged spleen and/or liver.

• A bone marrow biopsy shows hairy cells.
• A peripheral blood smear shows hairy cells.
• A tartrate-resistant acid phosphatase confirms hairy cells.
• An abdominal CT scan shows enlarged spleen and liver.
• A CBC shows low white blood cell count, low red cell count, and low platelets.

Treatment: Early in the course of the disease, treatment may not be necessary, but some people may require an occasional blood transfusion.

Palliative treatments (intended to reduce symptoms) are used with progression of the disease. Symptomatic treatment of infection with antibiotics, and treatment of bleeding episodes, are ongoing.

Interferon and experimental medications have been used with good response (the disease has gone into remission that lasts for several years).

Removal of the spleen has been a common treatment.

Prognosis: The expected outcome for this disease is improving with new treatments. Most patients with hairy cell leukemia can expect to live 10 years or longer.

Complications: Hairy cell leukemia can result in frequent episodes of infection and excessive bleeding.

Call for an appointment with your health care provider if symptoms indicate hairy cell leukemia may be present.

Call your health care provider if significant bleeding occurs. Also call if signs of infection are present, including persistent fever, cough, general ill feeling, or other symptoms.