Evaluation of Clinical Outcomes and Treatment Complications in Hairy Cell Leukemia: A Single-Center Retrospective Analysis

Background

Hairy cell leukemia (HCL) is a rare disorder characterized by splenomegaly, pancytopenia, and proliferation with “hairy” lymphocytes. Treatment is based on purine analogs and anti-CD20 antibodies, often resulting in significant adverse effects.

Aims

The objective of this study is to describe the frequency, clinical, and biological characteristics of a historic cohort of HCL patients in our center and the most common side effects related to treatment with purine analogs.

Methods and Results

This study analyzed 21 patients treated between 2009 and 2023, focusing on clinical characteristics, treatment response, complications, and survival outcomes. Cladribine treatment achieved complete response in 77.8% of patients. The 5-year OS and PFS were 100% and 91.7%, respectively. Infections, pathogens such as herpes viruses and mycobacteria, were major complications, impacting 38% of patients. Severe skin reactions were noted in patients treated with cladribine.

Conclusion

The study highlights cladribine's effectiveness in inducing remission in HCL patients, pointing out the significant risks of infections and other adverse effects. Introducing targeted treatments like BRAF inhibitors provides promising alternatives, especially for resistant patients or those intolerant to purine analogs. Future strategies should focus on integrating targeted therapies to reduce treatment-related morbidity.