Hairy
cell leukemia
Overview
Hairy cell leukemia is a cancer of the white
blood cells. The white blood cells help fight off germs. There are a few
different types of white blood cells. The white blood cells involved in hairy
cell leukemia are called B cells. B cells are also called B lymphocytes.
In hairy cell leukemia, the body makes too
many B cells. The cells don't look like healthy B cells. Instead,
they've undergone changes to become leukemia cells. The leukemia cells look
"hairy" under a microscope.
Hairy cell leukemia cells keep living when
healthy cells would die as part of the natural cell life cycle. The leukemia
cells build up in the body and cause symptoms.
Hairy cell leukemia often gets worse slowly.
Treatment might not need to start right away. When it's needed, treatment is
usually with chemotherapy.
Scientists found a type of cancer that looks
like hairy cell leukemia, but it gets worse much faster. This other type of
cancer is called hairy cell leukemia variant. It's considered a separate type
of cancer from hairy cell leukemia, even though it has a similar name.
Symptoms
Hairy cell leukemia might not cause symptoms.
Sometimes a health care provider finds it by accident during a blood test for
another condition.
When it causes symptoms, hairy cell leukemia
might cause:
·
A feeling of fullness
in your belly that may make it uncomfortable to eat more than a little at a
time
·
Fatigue
·
Easy bruising
·
Recurring infections
·
Weakness
·
Losing weight without
trying
When to see a doctor
Make an appointment with your health care
provider if you have any persistent signs and symptoms that worry you.
Causes
It's not clear what causes hairy cell
leukemia.
Hairy cell leukemia begins in the white blood
cells. The white blood cells help fight germs in the body. There are a few
types of white blood cells. The white blood cells involved in hairy cell
leukemia are called B cells.
Hairy cell leukemia happens when B
cells develop changes in their DNA. A cell's DNA contains the instructions
that tell a cell what to do. The changes tell the B cells to make a
lot more B cells that don't work right. These cells go on living when
healthy cells would die as part of the natural cell life cycle.
The B cells that don't work right
crowd out healthy blood cells in the bone marrow and other organs. This leads
to the symptoms and complications of hairy cell leukemia. For example, the
extra cells can cause swelling in the spleen, liver and lymph nodes. If there
isn't enough room for healthy blood cells, this can lead to frequent
infections, easy bruising and feeling very tired.
Risk factors
The risk of hairy cell leukemia may be higher
in:
·
Older
adults. Hairy cell
leukemia can happen at any age. But most people diagnosed with hairy cell
leukemia are in their 50s or 60s. It's rare in children.
·
Males. Hairy cell leukemia can happen to
anyone. But it's more likely in males.
Complications
Hairy cell leukemia often gets worse very
slowly. Sometimes it stays stable for many years. For this reason, few
complications of the disease occur.
Too few healthy blood
cells
If there are too many leukemia cells in the
body, they can crowd out the healthy blood cells. That can lead to:
·
Infections. Your body needs healthy white blood
cells to fight off germs. If your body can't make enough healthy white blood
cells, you might get more infections.
·
Bleeding. Your body needs healthy platelet cells
to control bleeding. If the number of platelets in your blood is low, you might
notice that you bruise more easily. You might also have bleeding from the nose
or gums.
·
Anemia. Your body needs healthy red blood cells
to carry oxygen through your body. Having too few red blood cells is called
anemia. Anemia can make you feel very tired.
Increased risk of
other cancers
Some studies found that people with hairy cell
leukemia have an increased risk of other types of cancer. The other cancers
include non-Hodgkin's lymphoma, Hodgkin's lymphoma and others. It's not clear
if the other cancers are caused by hairy cell leukemia or by cancer treatments.
Diagnosis
To diagnose hairy cell leukemia, your health
care provider may recommend:
·
Physical
exam. Your provider
may feel your spleen to see if it's too big. The spleen is an oval-shaped organ
on the left side of the upper abdomen. If your spleen is too big you might feel
a fullness in your belly. You might have pain or discomfort when you eat.
·
Blood
tests. You might have a
blood test to measure the levels of blood cells in your blood. This test is
called a complete blood count (CBC) with differential.
You have three main types of blood cells in your blood. They
include red blood cells, white blood cells and platelets. In hairy cell
leukemia, a CBC test may show all levels of these cells are too low.
Another type of blood test might involve looking at your blood
under the microscope. This test can find hairy cell leukemia cells. This test
is called a peripheral blood smear.
·
Bone
marrow biopsy. A bone marrow
biopsy is a procedure to remove some of your bone marrow for testing. Your
provider will remove a small amount of bone marrow from your hip area. This
sample is used to look for hairy cell leukemia cells.
·
Lab
tests to analyze the leukemia cells. Hairy cell leukemia cells collected from your blood and
bone marrow are tested in a lab. These tests look at the changes in the cells'
DNA. This helps your provider understand your prognosis and what treatments are
best for you.
·
Computerized
tomography (CT) scan. A CT scan
shows detailed images of the inside of your body. Your provider may order
a CT scan to look for swelling in your spleen and your lymph nodes.
Treatment
Hairy cell leukemia treatments are good at
controlling the disease. But they can't make it go away completely. Instead,
treatments can control the cancer so that you can go about your life as usual.
People with hairy cell leukemia can live with the disease for many years.
Treatment might not
need to start right away
Treatment for hairy cell leukemia doesn't
always need to start right away. This cancer often gets worse very slowly over
time. You might choose to wait and have treatment if the cancer starts to cause
symptoms.
If you don't have treatment, you'll have
regular appointments with your health care provider. You might have blood tests
to see if hairy cell leukemia is getting worse.
You might decide to start treatment if you
start to get hairy cell leukemia symptoms. Most people with hairy cell leukemia
will eventually need treatment.
Chemotherapy
Chemotherapy is a drug treatment that uses
powerful drugs to kill cancer cells. It's often the first treatment for hairy
cell leukemia. Chemotherapy is very effective for hairy cell leukemia. Most
people get a complete or partial remission after chemotherapy. Remission means
you have no signs of cancer.
Chemotherapy for hairy cell leukemia can be
given as a shot. Or it can be given as an infusion into a vein.
If your hairy cell leukemia comes back, your
provider might recommend repeating chemotherapy with the same drug or trying a
different drug. Another option may be targeted drug therapy.
Targeted drug therapy
Targeted drug treatments attack specific
chemicals present within cancer cells. By blocking these chemicals, targeted
drug treatments can cause cancer cells to die.
Targeted drug therapy is sometimes used as a
first treatment for hairy cell leukemia. It can be used with chemotherapy. More
often, targeted therapy is an option if the cancer comes back after
chemotherapy.
Your health care provider will have your
cancer cells tested to see whether targeted drug therapy is likely to work for
you.
Alternative medicine
No alternative medicines are helpful for
treating hairy cell leukemia. Alternative medicine might be helpful in other
ways. It may help you cope with the stress of a cancer diagnosis and the
treatment side effects.
Talk to your health care provider about your
options, such as:
·
Art therapy
·
Exercise
·
Meditation
·
Music therapy
·
Relaxation exercises
·
Spirituality
Coping and support
A cancer diagnosis can feel overwhelming. To
help you cope, you might consider trying to:
·
Find
out enough to feel comfortable making decisions about your care. Learn about hairy cell leukemia and
cancer treatments. This can help you feel more confident about making decisions
about your treatment. Ask your health care provider to suggest some reliable
sources of information to get you started.
·
Connect
with other cancer survivors. Friends and family provide an important support network
during your cancer experience. But they can't always understand what it's like
to face cancer. Other cancer survivors provide a unique network of support.
Ask your provider about support groups or organizations in your
community that can connect you with other cancer survivors. Organizations such
as the Hairy Cell Leukemia Foundation and the Leukemia & Lymphoma Society
offer ways to connect with others online.
·
Take
care of yourself. You can't
control whether your hairy cell leukemia comes back, but you can control other
aspects of your health.
Take care of yourself by eating a balanced diet with plenty of
fruits and vegetables. Exercise regularly. Get enough sleep so that you wake up
feeling refreshed. Find healthy ways to cope with the stresses in your life.
Preparing for your
appointment
Start by seeing your usual health care
provider if you have any symptoms that worry you. If your provider suspects you
may have hairy cell leukemia, they may suggest that you see a specialist. This
might be a doctor who treats diseases of the blood and bone marrow. This doctor
is called a hematologist.
Appointments can be brief, so it's a good idea
to be prepared. Here's some information to help you get ready.
What you can do
·
Be
aware of any pre-appointment restrictions. At the time you make the appointment, be sure to ask if
there's anything you need to do in advance. For example, you might need to
restrict your diet.
·
Write
down any symptoms you're experiencing, including any that may seem unrelated to the reason for
which you scheduled the appointment.
·
Write
down key personal information, including any major stresses or recent life changes.
·
Make
a list of all medications, vitamins
or supplements that you're taking.
·
Consider
taking a family member or friend along. Sometimes it can be hard to remember all the information
provided during an appointment. Someone who comes with you may remember
something that you missed or forgot.
·
Write
down questions to ask your doctor.
Your time with your provider is limited.
Prepare a list of questions so that you can make the most of your time
together. List your questions from most important to least important in case
time runs out. For hairy cell leukemia, some basic questions to ask include the
following:
·
What kinds of tests do
I need?
·
Will I need treatment
for my hairy cell leukemia?
·
If I don't have
treatment, will my leukemia worsen?
·
If I need treatment,
what are my options?
·
Will treatment cure my
hairy cell leukemia?
·
What are the side
effects of each treatment option?
·
Is there one treatment
you feel is best for me?
·
How will cancer
treatment affect my daily life?
·
I have these other
health conditions. How can I best manage them together?
·
Are there any
restrictions that I need to follow?
·
Should I see a
specialist? What will that cost, and will my insurance cover it?
·
Are there brochures or
other printed material that I can take with me? What websites do you suggest?
What to expect from
your doctor
Your provider is likely to ask you a number of
questions. Being ready to answer them may allow more time later to cover other
points you want to address. Your provider may ask:
·
When did you begin
having symptoms?
·
Have your symptoms
been continuous or occasional?
·
How severe are your
symptoms?
·
What, if anything,
seems to improve your symptoms?
·
What, if anything,
makes your symptoms worse?
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