Hairy cell leukaemia (HCL) is a rare type of chronicA long-lasting disease that changes slowly. leukaemia (chronic or slow-growing cancerA disease where abnormal cells split without control and spread to other nearby body tissue and/or organs. Cancer cells can also spread to other parts of the body through the bloodstream and lymph systems. of the bloodhello and blood forming tissues) that develops from lymphocytic white blood cells
• the smallest, living parts of the body. Cells work together to form or build the body
• a human is made up of millions of Cells
• Cells reproduce themselves to make sure a body stays working
• sometimes Cells can be abnormal or damaged and these can be cancer cells
. More specifically, they develop from B lymphocytes, or B-cells, which are responsible for producing the immunoglobins (antibodies) that help our body fight infections.
The naming of HCL comes from their cellular appearance under the microscope, where tiny hair-like projections are seen coming off the surface of leukaemic cells.
HCL has a higher incidence in males and is most commonly diagnosed in people over 50 years of age. However, anyone can develop this disease.
Treatment
If a HCL is detected, it will be staged and graded based on size, metastasisKnown as secondary cancer, it grows/spreads from the original/ primary cancer. (whether the cancer has spread to other parts of the body) and how the cancer cells look under the microscope. Staging and grading helps your doctors determine the best treatment for you.
Cancers can be staged using the TNM staging system:
- T (tumour) indicates the size and depth of the tumour.
- N (nodes) indicates whether the cancer has spread to nearby lymphA clear fluid that moves through the body through the lymphatic system, carrying cells that fight infection. nodes.
- M (metastasis) indicates whether the cancer has spread to other parts of the body.
This system can also be used in combination with a numerical value, from stage 0-IV:
- Stage 0: this stage describes cancer cells in the place of origin (or ‘in situ’) that have not spread to nearby tissue.
- Stage I: cancer cells have begun to spread to nearby tissue. It is not deeply embedded into nearby tissue and had not spread to lymph nodes. This stage is also known as early-stage cancer.
- Stage II: cancer cells have grown deeper into nearby tissue. Lymph nodes may or may not be affected. This is also known as localisedOnly to one area/place of body. cancer.
- Stage III: the cancer has become larger and has grown deeper into nearby tissue. Lymph nodes are generally affected at this stage. This is also known as localised cancer.
- Stage IV: the cancer has spread to other tissues and organs in the body. This is also known as advancedAt a late stage, far along or metastatic cancer.
Cancers can also be graded based on the rate of growth and how likely they are to spread:
- Grade
• A score that tells how quickly a tumour might spread and grow by looking at how the abnormal cells and tissue look under a microscope.
• Grade is not the same as stage.
• Grading is different depending on the type of cancer.
I: cancer cells present as slightly abnormal and are usually slow growing. This is also known as a low-grade tumour. - Grade II: cancer cells present as abnormal and grow faster than grade-I tumours. This is also known as an intermediate-grade tumour.
- Grade III: cancer cells present as very abnormal and grow quickly. This is also known as a high-grade tumour.
Once your tumour has been staged and graded, your doctor may recommend genetic testing, which analyses your tumour DNA and can help determine which treatment has the greatest chance of success. They will then discuss the most appropriate treatment option for you.
Treatment is dependent on several factors, including fertility, age, stage of disease and overall health.
Treatment options for patients with HCL may include:
- Chemotherapy
• a chemical drug treatment to kill or slow-growing cancer Cells
• these drugs are called cytotoxic drugs
. - Targeted therapies.
- Surgery, usually a total splenectomy (removal of the spleen).
- Watch and wait.
- Clinical trials.
- Palliative careLessening pain without curing the disease..
For more information on the treatment options, please refer to the Rare Cancers Australia Treatment Options page.
Risk factors
Because of how rare HCL is, there has been limited research done into the risk factors of this disease. However, a family history of HCL could potentially be a risk factor.
Symptoms
People with HCL may experience some of the following symptoms:
- AnaemiaWhere the number of red blood cells have dropped. This can make people feel tired, breathless and unwell and affects how the body fights infection, which carries its own set of symptoms:
- Tiredness.
- Dizziness.
- Paleness.
- Becoming unusually short of breath when physically active.
- Frequent and/or recurrent infections.
- Abdominal discomfort in the upper left side (spleen enlargement).
- Painless swelling of the lymph nodes.
Not everyone with the symptoms above will have cancer, but see your general practitioner (GP) if you are concerned.
Diagnosis/diagnosing
If your doctor suspects you have HCL, they will order a range of diagnostic tests to confirm the diagnosisUsing medical test results, identify and name a disease and/or condition., and refer you to a specialist for treatment.
Physical examination
Your doctor will collect your overall medical history, as well as your current symptoms. Following this, they may examine your body to check for any abnormalities.
Blood tests
Your doctor will recommend a blood test for check for signs of HCL. The most common test is a full blood countA test that counts red blood cells, white blood cells and platelets in the blood., which will analyse the levels of red blood cells, white blood cells and plateletsSmall blood cells (shaped like plates) whose job it is to come together in a group(s) or clump(s) to stop bleeding when you are injured or cut. in the blood. Low counts in any of these categories could be indicative of disease.
Imaging
The doctor will take images of your body using magnetic resonance imagingTaking images/photos of inside body parts using magnet rather than x-ray. (MRITaking images/photos of inside body parts using magnet rather than x-ray.), a computed tomography scan (CT scanA 3-D (three dimensional) x-ray pictures that gives more information than a normal x-ray.), and/or positron emission tomography (PET scanA test that uses a radioactive drug to show a picture of how your tissues and organs are working. Also known as a positron emission tomography scan.), to check for signs of metastasis.
Bone marrow biopsy
Once the location of the cancer has been identified, the doctor will perform a biopsyTo take a small piece of body tissue and test it in a laboratory. to remove a section of tissue using a needle. In most cases, this will be done by a bone marrowIs soft, spongy tissue found in bones that makes blood cells. aspiration and biopsy. This process involves inserting the needle into the hipbone (or the breastbone in some cases) to remove samples of solid and liquid bone marrow. These samples will then be analysed for cancer cells.