Hairy cell leukemia (HCL) is a lymphoproliferative disorder that usually presents itself as hematologic (blood) cancer. This type of cancer usually starts growing in the bone marrow where formation of blood cells takes place. It is a rare type of cancer, which is chronic in nature. It is named as such due to its appearance under a microscope having short, thin projections on its cells, which look like hair.
According to a research, hairy cell leukemia is likely to come back or relapse frequently with the 5-year relapse rates being 24-33% and 10 year relapse rate 42-48%. It can be successfully treated if diagnosed early. Therefore, recognizing the features and symptoms of hairy cell leukemia in early stages is very important. A good remission can also be achieved depending upon the severity of symptoms and disease.
Can Hairy Cell Leukemia Come Back?
Hairy cell leukemia has a high incidence of relapse and there is no permanent cure for it. Also sometimes drugs fail to achieve remission and another course of chemotherapy is required to treat hairy cell leukemia successfully. Regular monitoring of the symptoms and appropriate management with a healthy diet and lifestyle go a long way in managing leukemia. Thus, hairy cell leukemia can come back.
Causes and Symptoms of Hairy Cell Leukemia
The cause is not fully understood, but according to doctors it is mostly mutation of gene BRAF responsible for hairy cell leukemia. It has a male predominance thereby affecting males 5 times more than women. It is also more common in older people.
Hairy cell leukemia weakens the body’s immune system making it more prone to infections. In this there is an excessive production of white blood cells, which are harmful in nature called B cells (abnormal cells known as leukemia cells). They take up space of healthy cells in bone marrow and buildup in blood leading to hematological disorders.
In early stages, the disease may go unnoticed due to no obvious symptoms. Patient will either have no symptoms or vague symptoms of inflammation such as frequent fever with infections, fatigue or weakness.
The patient is easily bruised, presents with bone pain mostly in the ribs, splenomegaly (enlargement of the spleen) causes early satiety and abdominal pain, enlarged liver, excessive sweating especially at night, painless lumps in neck, groin, underarms or stomach, drastic weight loss and tendency to bleed easily.
Diagnosis of Hairy Cell Leukemia
A doctor will make diagnosis based on a person’s complete thorough medical history, physical examination and blood/bone marrow tests. A person’s history of present and past illness, treatments will give information about his health. To look for any unusual signs and symptoms (any lumps or swellings or enlarged lymph nodes suggestive of inflammation), a general body examination is done to assess the physical health.
A complete blood picture gives information of red blood cells, white blood cells and platelets count. It also gives information about the amount of hemoglobin attached to red blood cells. There are certain substances released into blood by organs and tissues in case of hairy cell leukemia signifying the disease. Visualization of leukemic cells under a microscope will show hairy appearance of cells.
The other diagnostic tests are bone marrow aspiration or biopsy which shows the diseased or leukemic cells on examination. Cytogenetic analysis is done to look for the presence of genetic abnormalities in the tissues and cells. Immunophenotyping will help analyze markers on the surface of blood or bone marrow cells, thereby helping it differentiate from healthy cells. A CT scan of the chest, abdomen and pelvis is done to look for swollen lymph nodes and spleen enlargement.
The treatment of hairy cell leukemia depends upon the proportion of healthy cells to leukemic cells in the blood and bone marrow and the persons overall general health status.
The disease is usually managed with chemotherauptic drugs such as clabridine and pentostatin. Bendamustine is also used in people who do not respond to other drugs. Immunotherapy is also being used these days, which help in strengthening the immune system of the patient.