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Hairy cell leukaemia. A review of nine cases
U Chudgar1, R V Shah, H Krishnaswamy
1Department of Haematology, Charistian Medical College and Hospital, Vellore, Tamil Nadu, S. India.
Insights
This study reviewed nine patients with Hairy Cell Leukemia (HCL), finding splenomegaly and pancytopenia common. Splenectomy offered rapid hematological recovery compared to alfa-interferon treatment.
Area of Science:
- Hematology
- Oncology
Background:
- Hairy Cell Leukemia (HCL) is a rare B-cell chronic lymphoid leukemia.
- Understanding HCL presentation and treatment outcomes is crucial for patient management.
Observation:
- Reviewed nine consecutive HCL patients over five years.
- Common symptoms included weakness and fatigue; splenomegaly was a frequent physical finding.
- Pancytopenia was a consistent hematological feature across most cases.
Findings:
- Diagnosis relied on bone marrow biopsy and electron microscopy (EM).
- Serious infections, primarily pneumonia and septicemia caused by gram-negative bacilli and fungi, occurred in 44% of patients.
- Splenectomy in four patients led to rapid hematological recovery without complications.
- Alfa-interferon treatment resulted in slower recovery, with one patient dying from infection-related complications and another achieving remission.
Implications:
- Splenectomy appears to be an effective treatment for HCL, offering rapid hematological improvement.
- Infections pose a significant risk in HCL patients, necessitating careful monitoring and management.
- Further research into optimal HCL treatment strategies is warranted, considering both efficacy and complication rates.
Abstract:
Nine consecutive patients with HCL seen over a period of five years were reviewed. Male: Female ratio was 8:1. Median age at diagnosis was 49 years. Weakness and fatigue (66%) were the commonest presenting symptoms and splenomegaly (66%) was the commonest physical findings. Varying degrees of pancytopenia was the consistent feature in majority of cases. Diagnosis was made on the basis of bone marrow biopsy and characteristic EM picture. Forty-four percent of cases developed serious infection during their clinical course. Gram negative bacilli and fungi were the most frequently isolated organisms. Major sites of infections were pneumonia and septicemia. Splenectomy was carried out in four cases. Rapid recovery of haematological parameters without any significant complication was observed in all these cases. Two patients were treated with alfa-interferon. In both the cases recovery of haematological parameters was slow compared to those under going splenectomy. One patient treated with alfa-interferon died due to infection related complications while the other went into remission.