When should treatment be initiated for hairy cell leukemia?

Updated: Jan 16, 2019
  • Author: Sandy D Kotiah, MD; Chief Editor: Emmanuel C Besa, MD  more...
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Many patients with classic HCL appear to be asymptomatic even after diagnosis, and about 10% will never require therapy. [14] Treatment should be initiated if the patient develops 1 or more of the following signs and symptoms:

  • Abdominal fullness or discomfort due to splenomegaly

  • Complaints of fatigue, weakness, and weight loss

  • Platelet count < 100,000/μL

  • Recurrent infections, which may be life-threatening, secondary to granulocytopenia and monocytopenia (absolute neutrophil count < 1000/µL; see the Absolute Neutrophil Count calculator)

  • Symptomatic anemia with a hemoglobin concentration < 11.0 g/dL

  • Vasculitis (rare)

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