Dr. M.J. Bazos,
Patient Handout
LEUKEMIA,
HAIRY CELL
About Your
Diagnosis
Hairy cell leukemia is a malignant disease of
the lymphocytes, a type of white blood cell. The name hairy cell leukemia
refers to the hair-like projections that can be seen on the malignant cells
under a microscope. The cause of hairy cell leukemia is unknown. No chemical or
radiation exposure has been definitively linked to development of the disease,
although one study found a weak association between hairy cell leukemia and
employment in woodworking and farming. Only 600 new cases are diagnosed every
year in the United States. Hairy cell leukemia is more common among men than
women, and it usually develops around middle age. Hairy cell leukemia is not
contagious. It rarely occurs in two or more members of the same family. However,
it is usually not hereditary. The diagnosis of hairy cell leukemia is made by
means of finding the characteristic hairy cells. This usually necessitates
biopsy of the bone marrow. Sometimes the diagnosis is be made by means of
examination of the blood. Sometimes the diagnosis may necessitate removal of the
spleen (splenectomy). Chemotherapy often leads to long-lasting complete
remission of hairy cell leukemia.
Living With Your
Diagnosis
The hairy cells infiltrate
the spleen and bone marrow, leading to the signs and symptoms of the disease.
Many patients with hairy cell leukemia have abdominal fullness or discomfort due
to expansion of the spleen in the left upper abdomen. Others have low blood
counts, because the hairy cells crowd out the normal blood cells formed in the
bone marrow (red blood cells, white blood cells, and platelets). A low red blood
cell count (anemia) can cause fatigue or shortness of breath. A low white blood
cell count (neutropenia) can increase susceptibility to infection. A low
platelet count (thrombocytopenia) can lead to easy bruising or bleeding.
Patients with hairy cell leukemia have extremely low white blood cell counts,
either because of the crowding out of normal white blood cells or as a side
effect of chemotherapy for hairy cell leukemia. Patients with neutropenia are at
high risk for bacterial infections and should avoid eating uncooked fruits,
vegetables, and milk products. These foods can harbor bacteria that are not
dangerous to healthy persons but might cause an infection in a person with
neutropenia. Patients with hairy cell leukemia who do not have neutropenia
should simply eat a healthful, balanced diet. Many patients with hairy cell
leukemia have a low tolerance for exercise because of anemia. They should stop
exercise at once if they experience dizziness, pain, or shortness of breath.
patients with hairy cell leukemia may have a thrombocytopenia, either because of
the hairy cell leukemia itself or as a side effect of chemotherapy. Patients
with hairy cell leukemia with platelet counts low enough to place them at
increased risk for bleeding should brush their teeth with a soft toothbrush and
shave only with an electric
razor.
Treatment
Not
all patients with hairy cell leukemia need immediate treatment. The most common
reasons for treatment are low blood counts or symptoms caused by an enlarged
spleen. New drugs have been found to be effective in hairy cell leukemia. The
most commonly used of these is called 2- chlorodeoxyadenosine (2-CDA,
cladribine). Patients receive the drug as a week-long intravenous infusion, and
about three fourths of patients have a complete response. Side effects of 2-CDA
include a temporary decrease in blood counts and numbness and tingling in the
fingers and toes. A low white blood cell count may lead to increased
susceptibility to infection. Decreased platelets may lead to increased risk for
bleeding.
The
DOs
• Participate in your
chemotherapy regimen as determined by your
physician.
• Eat a healthful diet if
you do not have neutropenia.
• Be
vaccinated against the influenza virus every fall. Also consider being
vaccinated to protect yourself against several types of
pneumonia.
• Brush your teeth with a
soft toothbrush and shave only with an electric
razor.
The
DON’Ts
• Avoid uncooked
fruits, vegetables, and milk products if you have
neutropenia.
• Avoid contact sports
if your platelet count is so low you are at increased risk for
bleeding.
• Stop exercise at once if
you experience dizziness, pain, or shortness of
breath.
When to Call Your
Doctor
• If you have a
fever.
• If you have any bleeding
that does not resolve after pressure is applied to the area for 5
minutes.