Treatment is not always required for individuals having hairy cell leukemia as this type of cancer has a slow progression rate and at times does not advance at all, some individuals would rather follow the wait and watch policy and prefer getting treated solely after they start becoming symptomatic. The major populace of individuals having hairy cell leukemia would ultimately require treatment.

Though one might be keen to free one’s body of any malignancy following diagnosis with hairy cell leukemia, there are no benefits of early treatment. In contrast to few other forms of cancer, hairy cell leukemia is relatively curable in all stages, translating to the fact that remission would not be any lesser if one adopted the wait and watch approach for treatment.

In case the presence of hairy cell leukemia is making a person symptomatic, then one could opt for undergoing treatment. Though hairy cell leukemia has no cure, still the bright aspect is that novel treatments are effectual in putting the disease in remission phase for several years.

Chemotherapy

Doctors have pegged the employment of chemotherapy drugs as the preliminary line of treatment for hairy cell leukemia. The vast populace of individuals would undergo a total or incomplete remission all through the chemotherapy course. The two kinds of chemotherapy drugs employed for treatment of hairy cell leukemia are:

• Cladribine (Leustatin)
  Majority of the treatment schedules for hairy cell leukemia start with cladribine. The patient would be given a continuous intravenous administration of the drug over a span of a week’s time. A total remission lasting for many years is often the case with majority of the individuals undergoing treatment with cladribine. In case hairy cell leukemia relapses, then re-treatment with cladribine is the course of therapy. Side effects experienced due to cladribine are infection and fever.
• Pentostatin (Nipent)
  Pentostatin has analogous remission rates as that of cladribine, however it is offered on a different regimen. Patients are given intravenous infusions of pentostatin every alternate week that would be continued till 6 months. The side effects due to pentostatin involve fever, infection, overly sensitive to light, inflammation in the eyes (keratoconjunctivitis), nausea and puking.

A small populace of individuals having hairy cell leukemia show resistance to chemotherapy meaning that they would fail to attain remission following the use of these drugs. Other individuals cannot take chemotherapy. For example, those having infections should steer clear from chemotherapy as these drugs repress the immune system and could worsen the existent small infections.

Biological Treatments (Immunotherapy)

Biological therapy or immunotherapy aims at making cancer cells more identifiable to the immune system. As soon as the immune system detects the cancer cells as offenders, it could start the annihilation process. The two kinds of biological treatments employed for treating hairy cell leukemia are:

• Alpha-interferon
  Alpha-interferon was the foremost biological drug that has garnered approval for cancer treatment. Alpha-interferon is generally suggested when chemotherapy has proven ineffectual or one is incapable of taking chemotherapy. Major populace of individuals treated with alpha-interferon taken over a span of a year have incomplete remission. Side effects faced are flu-similar signs like fever and exhaustion.
• Rituximab (Rituxan)
  Rituximab is a monoclonal antibody that has got approval for treatment of non-Hodgkin’s lymphoma, though it is at times employed in treating hairy cell leukemia. In case chemotherapy drugs failed to work or one cannot undergo chemotherapy, then the doctor could suggest rituximab. Side effects of rituximab involve bleeding, weariness, headaches and infection.

Surgery

Surgery for spleen removal (splenectomy) was the preliminary line of treatment employed for treating hairy cell leukemia, although it is used on occasional basis now-a-days. The doctor would suggest splenectomy in case there is a rupture or enlargement of the spleen and leading to pain or discomfort. Though removal of the spleen does not cure hairy cell leukemia, it could generally reinstate the normal blood counts. Hence due to this reason, splenectomy could be beneficial for individuals ailing from uninhibited infections. All surgical procedures have a risk of blood loss and infection. Spleen removal could lead to blood vessel inflammation (vasculitis) making one more prone to infection.

In case there are doubts about the presence of hairy cell leukemia then the doctor would be observant for the following three signs:

• Spleen enlargement.
• Lower count of all the types of blood cells.
• Presence of hairy cell leukemia in the blood.

In order to look out for these indicators the doctor would carry out several tests and examinations that would comprise of:

• Physical Examination
  The doctor would palpate the ellipsoidal-shaped organ placed to the left side of the upper part of the abdomen to check whether there is any kind of enlargement. An enlargement in the spleen could lead to feeling full in the abdomen that could cause discomfort during eating. The doctor might additionally look out for any enlargement in the lymph nodes that could point to the presence of cancer.
• Blood Analysis
  The blood sample collected is tested for CBC or complete blood count for gauging the blood count as those individuals with hairy cell leukemia have depleted counts of all kinds of blood cells namely red blood cells, white blood cells and platelets. Another type of blood test known as peripheral blood smear is conducted for checking the presence of hairy cell leukemia cells in the blood sample.
• Biopsy of the bone marrow
  During the course of a bone marrow biopsy, a minuscule quantity of bone marrow is extracted from the hip region. This sample is analysed for the presence of hairy cell leukemia and for keeping a watch on the normal, healthy blood cells.
• Computerised Tomography or CT or CAT scan
  A CAT scan reveals in-depth imagery of the internal parts of the body. The doctor would recommend undergoing a CAT scan for detecting whether the spleen and lymph nodes are having any kind of enlargement.

Possible Complications:

Hairy cell leukemia has a slow progression rate and at times, stay stabilised for several years. Hence due to this aspect there are fewer complications occurring. But, when not treated, hairy cell leukemia could advance and cause grave complications, like:

• Susceptibility to infection
  Depleted white blood cell count could make one more vulnerable to infections as the body’s infection combating capability is hindered due the presence of the disease.
• Easy Bruising and Blood clotting Problems
  Lowered platelet count could obstruct blood clotting. Hence, in case one is having a slightly lower platelet count, then one might observe being bruised more easily. Depleted platelet count could lead to unprompted blood loss from the nose or the gums.
• Low Haemoglobin Count
  A sapped red blood cell count would translate to lesser presence of cells for transporting oxygen all through the body leading to anemia that is known to cause immense weariness.
• Splenic Burst or Rupture
  A ruptured spleen could turn out to be a life-threatening situation the needs urgent surgical intervention for removal of the spleen. Hairy cell leukemia could inundate the spleen leading to its enlargement. Ultimately, the surplus cells lead to the spleen rupturing; however this kind of complication is quite atypical.

Annually in the United States, nearly 600-800 individuals are detected with hairy cell leukemia. Hairy cell leukemia is observed to affect the male gender greater than the female, occurring mostly in the middle-age bracket or elderly individuals. Hairy cell leukemia is not known to affect kids and those in their teens.

Doctors are uncertain regarding the reasons that lead to the development of hairy cell leukemia. Hairy cell leukemia is deemed as an unremitting disease as it could never totally ebb, though treatment could cause a reduction for some years.

Hairy Cell leukemia symptoms:

Some of the individuals could be asymptomatic, though blood analysis for another ailment could involuntarily divulge the presence of hairy cell leukemia in the blood.

On other occasions, those having hairy cell leukemia could exhibit certain signs and symptoms that are analogous to number of ailments and conditions, like:

• A sense of fullness in the abdominal region that could lead to a discomforting feeling, preventing one from eating more than a miniscule amount at any instant.
• Weariness.
• Getting easily bruised.
• Persistent infections.
• Feeling weak.
• Reduction in weight.

Hairy Cell Leukemia Causes:

Cancers that occur due to the presence of a flaw in one’s DNA. In hairy cell leukemia, the mutations in the DNA could lead to the bone marrow stem cells excessively producing improperly functioning white blood cells. It is still fuzzy what the precise reasons are behind the DNA mutations that cause hairy cell leukemia.

Hairy Cell Leukemia Risk Factors:

Particular factors could raise one’s chances of developing hairy cell leukemia. Several research studies fail to concur on the exact factors that raise an individual’s risk of developing the disease. Several researches suggest various factors that might raise one’s risk of hairy cell leukemia, namely:

• Hairy cell leukemia is at times noted in those families that have a history of this form or other kinds of blood cancers.
• Men belonging to the Ashkenazi Jewish race are more prone to developing hairy cell leukemia.
• In case one has earlier had another kind of cancer then one could most probably develop hairy cell leukemia.
• Those individuals that have being exposed to radiation. For instance, those who have worked in close proximity to X-ray devices and other kinds of medical apparatus that emit ionizing radiation could be at increased risk of developing hairy cell leukemia. However, some researches have not detected this to be true.
• Being exposed to chemicals like those employed in farming and petroleum produce, could don a role in the development of hairy cell leukemia. Few studies have shown this to be a falsity.
• Being exposed to sawdust could also raise one’s chances of developing hairy cell leukemia. Though there have been varied reactions, few studies have detected a relation in between having worked with sawdust and wood and a heightened risk of developing hairy cell leukemia.

Cladribine is a cancer or antineoplastic medication for treating a form of blood cancer (Hairy Cell Leukemia) that hinders the spread of cancer cells, retarding their growth and proliferation in the body. Cladribine, however, has been additionally employed for other purposes.

Likely Side effects of cladribine (Cladribine Novaplus, Leustatin)

In case one is experiencing any of the below stated grave side effects, then it is vital to seek prompt medical assistance or get in touch with one’s doctor urgently.

• An allergic reaction characterised by shortened breath; feeling a restricted or closed sensation in the throat; breathing distress; the lips, face or tongue swelling up or appearance of hives.
• Lowered functioning of the bone marrow and blood complications (intense weariness or exhaustion; abnormal bruising or blood loss; blackish, blood-inundated or tar-like stools; fever; getting chills, soreness in the throat, or symptoms of an infection.
• Muscular weakness.
• Reduced frequency of urinating or difficulty felt during passage of urine, presence of blood in the urine, or side pain.
• Fever.

Other less grave side effects could most likely occur. Hence, it is imperative to inform the doctor in case one is experiencing:

• Feeling nauseous, puking, diarrhea or pain felt in the abdomen
• Diminished appetite
• Appearance of rashes, scratchiness or hives
• Coughing
• Giddiness
• Headaches

There could be other side effects besides those mentioned above and one needs to keep one’s doctor informed regarding any unusually felt side effects or those that are particularly irksome.

Vital Information regarding Cladribine (Cladribine Novaplus, Leustatin)

Cladribine must solely be administered under the care and guidance of an experienced healthcare provider adept at using cancer chemo-remedial agents. Grave side effects inclusive of neurologic, kidney problems among others have been cited.

Contraindications of Cladribine

Prior to starting on cladribine, the doctor needs to be informed about whether one has:

• Lately had any inoculations
• Liver ailments
• Kidney ailments
• Problems concerning bone marrow

One might be able to start taking cladribine or might need a dose alteration or special surveillance during the course of the treatment in case one is having any of the above mentioned conditions. This translates to the fact that cladribine has been shown to cause congenital anomalies in the unborn child. Hence, it is important to firstly speak with one’s doctor in case one is expecting or could have the likelihood of getting pregnant during the course of the treatment.

It is still unclear whether cladribine could be passed into breast milk. Hence in case one is breastfeeding, it is crucial to firstly speak to the doctor and not take cladribine.

The manner of administration of Cladribine (Cladribine Novaplus, Leustatin)

Cladribine would be best administered in the presence of an experienced healthcare professional proficient in the usage of cancer chemotherapeutic agents.

The doctor would ascertain the appropriate quantity and regularity of the treatment with cladribine dependent on the kind of cancer that is being treated and other associated factors.

The doctor would mostly suggest undergoing blood analysis on a regular basis and other medical assessments during the course of the treatment using cladribine for monitoring improvement and side effects.

Skin that has been mistakenly been exposed to cladribine needs to be scrupulously cleansed with soap and tepid water.

The healthcare provider would be storing cladribine as per directions of the manufacturer. In case one is storing cladribine, then it is vital to adhere to the directions offered by the healthcare provider.

Overdose or Missed out on a Dose – What must one do?

In case, one misses out on a dose, then it is vital to inform the doctor about it.

In case of an overdose is doubted, then it is vital to promptly get medical assistance as the signs of overdose tend to be analogous to those of the side effects occurring due to the medication, however have greater intensity.

When Cladribine must be avoided

Cladribine could lessen the activity of the immune system making one more vulnerable to contracting infections. Hence, it is important to keep away from people that are having colds, flu or other kinds of communicable diseases and not to receive inoculations that have live viral strains (for instance live oral polio vaccine) while getting treated with cladribine. Additionally, averting contact with people that have lately been inoculated with a live vaccine as there is a likelihood of the virus getting transmitted to you.

Inadvertent exposure of the skin to cladribine injection must be carefully washed off with tepid water and soap.

Another crucial aspect is that one must not receive ‘live’ innoculations while undergoing treatment with cladribine as administration of a live vaccine could prove detrimental. There are other kinds of medications that could counteract with cladribine. Hence, one needs to speak to the doctor and pharmacist prior to obtaining any other kinds of prescription or over-the-counter medicines inclusive of herbal produce during the course of the treatment with cladribine.