Dr Rahul Bhargava Haematologist

MBBS, MD, DM (Clinical Haematology)

Principal Director & Chief Hematology at Fortis Hospital

MBBS, MD, DM (Clinical Haematology)

Principal Director & Chief Hematology at Fortis Hospital

Hairy Cell Leukemia:

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Frequently Asked Questions (FAQ) :

 While hairy cell leukemia is not considered curable, it is highly treatable. Most patients achieve long-term remission with appropriate therapy.

 HCL is a rare type of chronic leukemia with slow progression and distinctive “hairy” cells. It differs from other leukemias in terms of its genetic mutations and treatment approaches.

 Yes, HCL can relapse after treatment, but most patients respond well to additional therapy. Regular follow-up is important for monitoring the disease.

 Common side effects include fatigue, nausea, increased risk of infection, and low blood cell counts. Most side effects are manageable and temporary.

 It’s always a good idea to seek a second opinion, especially with a rare condition like HCL. Dr. Rahul Bhargava can provide expert consultation to ensure the best treatment plan.

About Hairy Cell Leukemia

Hairy cell leukemia (HCL) is a rare, slow-growing type of chronic lymphocytic leukemia, a cancer of the blood and bone marrow. The disease gets its name from the appearance of the cancerous B cells under a microscope, which have fine, hair-like projections. This condition typically affects middle-aged and older adults and is more common in men than women. Dr. Rahul Bhargava, a renowned hematologist, specializes in diagnosing and treating hairy cell leukemia, offering patients personalized care and the latest treatment options.

Types of Hairy Cell Leukemia

Hairy cell leukemia is primarily classified into two types based on clinical presentation and genetic characteristics:

  1. Classic Hairy Cell Leukemia: This is the most common form, characterized by the presence of the BRAF V600E mutation in the cancer cells. It usually presents with symptoms such as fatigue, infections, and an enlarged spleen.
  2. Variant Hairy Cell Leukemia (HCL-V): This is a rarer and more aggressive form of HCL that does not have the BRAF mutation. Patients with HCL-V often have a higher white blood cell count and may not respond as well to standard treatments.

Causes of Hairy Cell Leukemia

The exact cause of hairy cell leukemia is not well understood, but several factors may contribute to its development:

  1. Genetic Mutations: The most common mutation associated with HCL is the BRAF V600E mutation, which plays a critical role in the growth and survival of the cancer cells.
  2. Age and Gender: HCL primarily affects middle-aged men, although it can occur in women and younger individuals.
  3. Environmental Factors: Some studies suggest that exposure to certain chemicals, such as pesticides, might increase the risk of developing HCL, though the evidence is not conclusive.

Symptoms of Hairy Cell Leukemia

The symptoms of hairy cell leukemia can vary widely, and in some cases, individuals may not experience symptoms until the disease is advanced. Common symptoms include:

  1. Fatigue and Weakness: Due to anemia and the body’s reduced ability to produce healthy blood cells.
  2. Frequent Infections: Caused by a low white blood cell count, making the body more susceptible to infections.
  3. Enlarged Spleen (Splenomegaly): This is one of the hallmark signs of HCL and can cause discomfort or a feeling of fullness in the abdomen.
  4. Easy Bruising or Bleeding: Resulting from a low platelet count.

Diagnosis of Hairy Cell Leukemia

Diagnosing hairy cell leukemia involves several steps, including:

  1. Physical Examination: Checking for signs such as an enlarged spleen or liver, as well as assessing the patient’s general health.
  2. Blood Tests: A complete blood count (CBC) and peripheral blood smear can reveal abnormal levels of blood cells and the presence of hairy cells.
  3. Bone Marrow Biopsy: A small sample of bone marrow is taken to confirm the diagnosis and determine the extent of the disease.
  4. Flow Cytometry: This test analyzes the characteristics of the cells in the blood or bone marrow, helping to identify the specific type of leukemia.
  5. Molecular Testing: Testing for the BRAF V600E mutation can confirm the diagnosis of classic HCL and guide treatment decisions.

Treatment of Hairy Cell Leukemia

The treatment approach for hairy cell leukemia depends on the type of HCL, the patient’s overall health, and the severity of symptoms:

  • Chemotherapy: The standard treatment for HCL is chemotherapy with purine analogs such as cladribine or pentostatin. These drugs are highly effective, often leading to long-term remission.
  • Targeted Therapy: For patients with the BRAF V600E mutation, targeted therapy with BRAF inhibitors (such as vemurafenib) can be an effective treatment option.
  • Immunotherapy: Monoclonal antibodies like rituximab are sometimes used in combination with chemotherapy or as a standalone treatment in cases of relapsed or refractory HCL.
  • Splenectomy: In some cases, removing the spleen may be necessary, particularly if it is significantly enlarged and causing symptoms.
  • Watchful Waiting: For patients with mild symptoms or slow progression, a watch-and-wait approach may be appropriate, with regular monitoring for any changes in the disease.

Cost of Treatment and Stay in India

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