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Initial alkylating agent chemotherapy in a leukemic hairy cell patient
American Journal of Hematology
|January 1, 1984
Summary
Initial chlorambucil therapy effectively treated hairy cell leukemia in a patient with a significant leukemic phase. This approach managed splenomegaly and leukocytosis, offering an alternative to immediate splenectomy.
Area of Science:
- Hematology
- Oncology
Background:
- Hairy cell leukemia (HCL) is a rare B-cell chronic lymphoid leukemia.
- The leukemic phase of HCL can present with significant leukocytosis and splenomegaly.
Observation:
- A patient with moderate splenomegaly and leukemic phase HCL had a WBC of 85,600/mm3 (87% hairy cells) and platelets of 125,000/mm3.
- Initial treatment involved daily chlorambucil at 4 mg.
Findings:
- Within 6 months, WBC decreased to 27,000/mm3 (82% hairy cells), and the spleen became non-palpable.
- Platelet count remained stable at 142,000/mm3.
- The patient remained well for 2 years, requiring no transfusions and experiencing no organ infiltration complications.
Implications:
- Selected HCL patients with a significant leukemic phase and mild thrombocytopenia may benefit from initial chlorambucil therapy.
- This suggests a potential non-surgical treatment option for specific HCL presentations, avoiding immediate splenectomy.