Hairy cell leukemia. Durability of response to splenectomy in 26 patients and treatment of relapse with androgens in six patients.
Twenty-three of 26 patients with hairy cell leukemia evaluable for response to splenectomy had significant improvement in anemia, thrombocytopenia, and/or neutropenia. Eight of the 23 had a recurrence of cytopenia after a median response duration of 4 to 5 months (range, 1-22). The remaining 15 patients did not have a recurrence of cytopenia at 20 months median follow-up (range, 1-76). Six patients with postsplenectomy cytopenia were given androgenic steroids. Two of the six had an improvement in anemia and thrombocytopenia, and a third patient had an improvement in neutropenia. It was concluded that, although most patients with hairy cell leukemia have initial improvement in cytopenia with splenectomy, a significant number of them either fail to respond or have recurrent cytopenia after initial response to splenectomy. A trial of androgenic steroids is a reasonable therapeutic option in these patients. Alternative therapies are reviewed and recommendations made.
D000328:Adult; D000368:Aged; D045930:Anabolic Agents / Q000627:therapeutic use*; D005260:Female; D005474:Fluoxymesterone / Q000627:therapeutic use; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007943:Leukemia, Hairy Cell / Q000097:blood / Q000188:drug therapy / Q000628:therapy*; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D009504:Neutrophils; D010110:Oxymetholone / Q000627:therapeutic use; D010976:Platelet Count; D012008:Recurrence; D013156:Splenectomy
D045930:Anabolic Agents; D006454:Hemoglobins; D005474:Fluoxymesterone; D010110:Oxymetholone