How is hairy cell leukemia (HCL) relapse treated?

Updated: Sep 16, 2018
  • Author: Emmanuel C Besa, MD; Chief Editor: Koyamangalath Krishnan, MD, FRCP, FACP  more...
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In patients who relapse within 2 years after monotherapy, it is important to differentiate classic hairy cell leukemia from the variant form. If classic hairy cell leukemia is confirmed, the patient should be considered for re-treatment with an alternative purine analogue or combination chemoimmunotherapy. [36]

Therapy with rituximab alone given in 4 or 8 weekly courses produces responses less impressive than combination therapy with a purine analogue, which is effective in patients who relapse after initial monotherapy. However, there are no randomized trials to conclusively prove that combination chemoimmunotherapy is more effective than monotherapy and that simultaneous purine analogue therapy is better than deliveriy of treatment in series.

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