What is the treatment for hairy cell leukemia?

Hairy cell leukemia is a distinctive type of leukemia characterized by the proliferation of B lymphocytes that have hair-like projections when viewed under a microscope. The disease often leads to splenomegaly, peripheral blood cytopenias, and characteristic findings in the bone marrow.

The most effective treatment for hairy cell leukemia involves the use of nucleoside analogs, particularly cladribine and pentostatin. These agents are effective because they target the hairy cell population selectively, leading to a reduction in the abnormal cells. Cladribine acts as a purine analog, disrupting the DNA synthesis and leading to apoptotic cell death. Pentostatin also inhibits ribonucleotide reductase and leads to the accumulation of toxic metabolites in malignant cells.

Chemotherapy may be used in general for various hematological malignancies, but in the context of hairy cell leukemia, the nucleoside analogs have shown superior efficacy and a more favorable side effect profile. Monoclonal antibodies have been effective in some types of leukemias and lymphomas, but they are not the frontline treatment for hairy cell leukemia. Bone marrow transplant is typically used in cases of resistant or aggressive disease, but it is not the initial therapy due to the effectiveness of nucleoside