What Is Hairy Cell Leukemia?
Hairy cell leukemia (HCL) is a rare type of blood and bone marrow
cancer that affects your B lymphocytes, which are white blood cells that make
antibodies to fight infections. If you have HCL, your body produces a surplus
of abnormal B lymphocytes that don’t function properly. These abnormal cells
can take up the space of healthy B lymphocytes, which can weaken your immune
system and make you susceptible to infections.
While the production of abnormal B lymphocytes is the hallmark of
this disease, your body’s increased production of these abnormal cells can also
cause a decrease in red blood cells and platelets. HCL gets its name because
the abnormal white blood cells look hairy under a microscope. Rare cases of
hairy cell leukemia affect T lymphocytes, which are cells that help B lymphocytes
While the exact cause of HCL is unknown, some research shows a
relationship between this type of cancer and exposure to the herbicide Agent
Orange, which was used to destroy crops and jungle canopy during the Vietnam
War. If you’re a veteran who has HCL and were exposed to Agent Orange during
the Vietnam War, you may qualify for disability and healthcare benefits from
States Department of Veterans Affairs.
What Are the Symptoms of Hairy Cell Leukemia?
Common symptoms of HCL include:
- persistently feeling tired
- weight loss for no reason
- shortness of breath
- excessive sweating, often at night
- swollen lymph nodes
- frequent infections and fevers
- small red spots on the skin
- an enlarged liver or spleen
- easy bruising and bleeding
- bone pain, especially under the ribs
HCL progresses slowly, and in its early stages, you may
experience few or no symptoms at all.
When to Call Your Doctor
If you have HCL, it is important to keep an eye out for symptoms
that the cancer is progressing. Call your doctor if you generally don’t feel
well or if you have any of the following:
- a lot of bleeding
- an infection
- a persistent fever
- a persistent cough
These may suggest that your white blood cell count is low. Proper
care and timely treatment are crucial for your health.
This type of cancer affects more men than women, and most HCL
diagnoses are made in people over 50 years of age.
How Is Hairy Cell Leukemia Diagnosed?
Your doctor may suspect HCL based on your symptoms or if signs of
the disease are present during a physical exam. Tests your doctor may perform to
reach a diagnosis include the following:
- A CT scan takes detailed images of
your body and allows your doctor to view certain organs, such as the spleen or
liver, which can be swollen if you have HCL.
- A complete blood count is a measure
of the amount of white and red blood cells and platelets in your blood.
- A peripheral blood smear is a test
in which your blood is viewed under a microscope to look for hairy cells.
- If you have a bone marrow biopsy,
your doctor will remove a small sample of your bone marrow using a hollow
needle. The sample will be viewed under a microscope for signs of cancer.
- A sample of your blood cells or bone
marrow may be examined under a microscope for certain markers, such as protein
patterns, that are found on the surface of HCL cells. This is called
How Is Hairy Cell Leukemia Treated?
Treatment will vary depending on the number of hairy cells and
healthy cells in your blood and bone marrow, and whether you exhibit certain symptoms,
such as a swollen or infected spleen. While some treatments may relieve and
manage symptoms, none are known to cure it completely. You may need treatment
if your normal blood cell counts are low, your spleen is swollen, or if you
have an infection.
Common treatments include:
- blood transfusions to increase blood count
- chemotherapy treatments to kill abnormal cells
- surgery to remove a swollen spleen
- antibiotics to cure infection
If your HCL isn’t progressing and if you don’t have symptoms, your
condition should be monitored but it may not require immediate treatment.
What Is the Outlook for People with Hairy Cell Leukemia?
Treatment and recovery will depend on whether there’s a
continuous increase in the number of hairy cells and the rate at which these
cells develop. Most cases of HCL respond well to treatment and usually result
in long-term remission, which occurs when the cancer has stopped progressing
and your symptoms have gone away. If your symptoms return and the cancer begins
to progress again, you may need to go through treatment again to put the cancer
back into remission.