Hairy cell leukaemia

Hairy cell leukaemia (HCL) is an uncommon, indolent, mature B-cell neoplasm. It is characterised by symptoms of fatigue, a markedly enlarged spleen, and a distinctive histological appearance on peripheral blood smear and bone marrow biopsy.

The disease is not curable. However, it is highly responsive to therapy and may be managed successfully for a decade or more.

Patients who are without symptoms do not require immediate treatment; early treatment does not extend life expectancy.

In symptomatic patients, purine analogues have largely replaced traditional therapies, such as splenectomy, except in rare cases of splenic rupture or massive splenomegaly.

Supportive care with antibiotics, non-steroidal anti-inflammatory drugs, administration of irradiated blood products, and granulocyte colony-stimulating factors may have a role in therapy for HCL.

Hairy cell leukaemia (HCL) is an uncommon, indolent, mature B-cell neoplasm. Seen under the microscope, the cells have delicate cytoplasmic projections resembling hair (‘hairy cells’). The disease has a characteristic presentation of pancytopenia, splenomegaly, and hairy cells in the circulation, marrow, and other haematopoietic organs.[Figure caption and citation for the preceding image starts]: Cytospin prepared from bone marrow aspirate illustrates the typical cell cytology, with oval- to bean-shaped nuclei and moderate amounts of cytoplasm with irregular cytoplasmic borders (Wright Giemsa 100x oil)From the collection of Lynn Moscinski, MD [Citation ends].[Figure caption and citation for the preceding image starts]: Sections of core biopsy demonstrate lymphocytes with obvious cytoplasm within the marrow interstitium, associated with dilatation of marrow sinuses and red blood cell collections (H&E 50x oil)From the collection of Lynn Moscinski, MD [Citation ends].