The optimal management of hairy cell leukaemia

Area of Science:

• Hematology
• Oncology
• Pharmacology

Background:

• Hairy cell leukaemia is a rare B cell chronic lymphoproliferative disorder.
• Treatment is indicated for severe cytopenias or recurrent infections.
• Traditional therapies include splenectomy and interferon-alpha (IFN alpha), with limited efficacy and notable side effects.

Purpose of the Study:

• To review the therapeutic landscape for hairy cell leukaemia.
• To compare the efficacy and toxicity of novel purine analogues against established treatments.

Main Methods:

• Review of existing literature on hairy cell leukaemia treatments.
• Comparative analysis of response rates, remission durations, and adverse events for different therapies.

Main Results:

• Interferon-alpha (IFN alpha) induces partial responses in most patients but complete responses in few.
• Pentostatin and cladribine, purine analogues, induce long-lasting complete remissions in the majority of patients.
• Cladribine demonstrates a favourable toxicity profile, brief treatment duration, high unmaintained complete remission rates, and low relapse incidence.

Conclusions:

• Cladribine is emerging as the preferred treatment for hairy cell leukaemia.
• Purine analogues have revolutionized the management of this rare lymphoid malignancy.
• The shift in treatment paradigms prioritizes efficacy, safety, and patient outcomes.