What is included in long-term monitoring of patients with 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 is usually indolent and protracted; late relapses occur. Long-term outpatient follow-up is necessary in most patients.

Evaluation of minimal residual disease by posttreatment bone marrow biopsies using anti-CD20 by flow cytometry reveals that 13-51% of patients in apparent CR had minimal residual disease. The presence of minimal residual disease appears to predict clinical relapse. Because a majority of patients respond very well to retreatment (92% response) or salvage treatment (80% response), no evidence supports treatment of minimal residual disease.

Newer therapies, such as the anti-CD20 monoclonal antibody rituximab, have been tested in patients with hairy cell leukemia that was refractory to standard treatment. In studies with small numbers of patients who received rituximab, results ranged from an overall response of 64% with a median duration of response of 14 months, to 100% response with a duration of 73 months, indicating that this form of therapy is active against hairy cell leukemia.

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