What is the prognosis of hairy cell leukemia (HCL)?

Updated: Sep 16, 2018
  • Author: Emmanuel C Besa, MD; Chief Editor: Koyamangalath Krishnan, MD, FRCP, FACP  more...
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Hairy cell leukemia behaves like a chronic leukemia. With treatment, most patients achieve clinical remissions and, sometimes, long-term cures. In the United States, 5-year survival ranged from 84% to 94% (lower in blacks than whites). [8]

The risk of second malignancies has been observed in patients with hairy cell leukemia, either through the disease itself or secondary to the immunosuppressive effects of the therapy. Skin cancers (ie, melanoma and non-melanoma) are the most common, representing 33-36% of all secondary malignancies. Other malignancies include prostate cancers, gastrointestinal malignancies, non-Hodgkin lymphomas, and ovarian, cervical, and breast cancer. [10]

A 20-year follow-up in 117 patients in British Columbia showed that 31% developed a second malignancy, of which 30% were diagnosed before hairy cell leukemia was found. [11]  On the other hand, an MD Anderson study reported no excess of second malignancies among 350 patients with hairy cell leukemia who were treated with interferon alfa, cladribine, or pentostatin. [12]

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