Diagnosis of Hairy Cell Leukemia

Diagnosis of Hairy Cell Leukemia

The following tests and procedures may be used to diagnose hairy cell leukemia:
  • Physical exam and history: An exam of the body to check general signs of health, including checking for signs of disease, such as a swollen spleen, lumps, or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.
  • Complete blood count (CBC): A procedure in which a sample of blood is drawn and checked for the following:
    • The number of red blood cells, white blood cells, and platelets.
    • The amount of hemoglobin (the protein that carries oxygen) in the red blood cells.
    • The portion of the sample made up of red blood cells.
  • Peripheral blood smear: A procedure in which a sample of blood is checked for cells that look “hairy,” the number and kinds of white blood cells, the number of platelets, and changes in the shape of blood cells.
  • Bone marrow aspiration and biopsy: The removal of bone marrow, blood, and a small piece of bone by inserting a hollow needle into the hipbone or breastbone. A pathologist views the bone marrow, blood, and bone under a microscope to look for signs of cancer.
  • Immunophenotyping: A test in which the cells in a sample of blood or bone marrow are looked at under a microscope to check the pattern of proteins those are on the surface of the cells. Hairy cells have a certain pattern.
  • CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography. A CT scan of the abdomen may be done to check for swollen lymph nodes or a swollen spleen.
Factors Affecting Prognosis and Treatment Options The treatment options of hairy cell leukemia may depend on the following:
  • The number of hairy (leukemia) cells and healthy blood cells in the blood and bone marrow.
  • Whether the spleen is swollen.
  • Whether there are symptoms of leukemia, such as infection.
  • Whether the leukemia has recurred (come back) after previous treatment.
The prognosis (chance of recovery) depends on the following:
  • Whether the hairy cell leukemia does not grow or grows so slowly it does not need treatment.
  • Whether the hairy cell leukemia responds to treatment.

Stages of Hairy Cell Leukemia

Staging is the process used to find out how far the cancer has spread. There is no standard staging system for hairy cell leukemia. Groups are used in place of stages for hairy cell leukemia. The disease is grouped as untreated, progressive, or refractory.

Untreated Hairy Cell Leukemia

The hairy cell leukemia is newly diagnosed and has not been treated except to relieve symptoms such as weight loss and infections. In untreated hairy cell leukemia, some or all of the following conditions occur:
  • Hairy (leukemia) cells are found in the blood and bone marrow.
  • The number of red blood cells, white blood cells, or platelets may be lower than normal.
  • The spleen may be larger than normal.

Progressive Hairy Cell Leukemia

In progressive hairy cell leukemia, the leukemia has been treated with either chemotherapy or splenectomy (removal of the spleen) and one or both of the following conditions occur:
  • There is an increase in the number of hairy cells in the blood or bone marrow.
  • The number of red blood cells, white blood cells, or platelets in the blood is lower than normal.
Cancer cells spread in the body through blood, lymph system or solid tissue. When cancer cells spread outside the blood, a solid tumor may form. This process is called metastasis.

Relapsed or Refractory Hairy Cell Leukemia

Relapsed hairy cell leukemia has come back after treatment. Refractory hairy cell leukemia has not responded to treatment. If you have symptoms associated with hairy cell leukemia, contact us to request an appointment with our oncology specialists to begin diagnostic testing.