[Local Medical]Hairy cell leukemia with onset age between 50 and 55 years old should be followed closely

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Text: Chen Xiaoquan Compiled by: Liang Yingxiu

(Kuala Lumpur News) Hairy cell leukemia is a rare blood cancer and a B lymphocyte (B lymphocyte) proliferation disease. The incidence rate only accounts for 2% of the total leukemia cases. The disease progresses very slowly and can lie dormant in a patient’s cells for years before causing problems.

Abnormal blood cells traveling throughout the body

Dr Muhd ​​Zanapiah Zakaria, consultant hematologist, pointed out that blood is composed of different types of cells, which come from the bone marrow. With hairy cell leukemia, the patient’s bone marrow produces abnormal blood cells. Due to uncontrolled growth, it enters the blood and travels throughout the body. Sometimes, these cells gather in one part of the body.

He said that the symptoms of hairy cell leukemia depend on the stage. In the early stages, there are no symptoms, and in the later stages, patients will have bone marrow failure syndrome. This syndrome causes a decrease in the production of red blood cells, white blood cells and platelets, heme, or bone marrow, causing patients to develop anemia, white blood cells, and thrombocytopenia.

“When the bone marrow makes abnormal red blood cells, it cannot make enough blood cells normally that the body needs. This may cause certain symptoms in the body, including feeling tired or weak, unexplained weight loss, bleeding more easily than usual, bruising, or being susceptible to infections. And disease, so complications depend on the disease’s effect on the blood. These leukemia cells can also accumulate in the spleen, making it enlarged and causing abdominal pain.”

People exposed to ionizing radiation are at high risk

He said these symptoms may not be caused by hairy cell leukemia, but if you have these symptoms, you must inform your doctor or health care provider. Some people with hairy cell leukemia may not have any symptoms, especially in the early stages. People may not find out they have the disease until after a physical exam or blood test.

Generally, doctors will require a number of different blood tests and bone marrow biopsies after consultation and clinical examination. During a bone marrow biopsy, doctors take a small sample of the patient’s bone marrow and analyze it to look for any abnormalities or cancer cells.

High-risk groups for hairy cell leukemia include those who are frequently exposed to ionizing radiation and those exposed to chemical substances. Therefore, all people suffering from the disease are adults, the age of onset is 50 to 55 years old, and the male to female ratio is 4:1. There are no children or teenagers with the disease. Studies in the United States have shown that the disease is more common in whites than blacks, but there is still no data on the disease in Malaysia.

Treatment of hairy cell leukemia depends on whether the patient has symptoms. If the patient does not have any symptoms, immediate treatment is not required, but the treating doctor will closely follow the patient’s condition through examinations and blood tests until treatment is needed.

Mohd cited two clinical cases, saying that there was once a patient with no symptoms. After a blood test, it was found that the red blood cell index was slightly low. After a bone marrow biopsy was performed on him, he was diagnosed with hairy cell leukemia. Finally, after waiting 3 to 4 months and closely tracking the blood condition and observing the progression of the disease, the doctor can start formal treatment.

Another patient has symptoms such as low red blood cell index and fever. At this time, the patient needs immediate treatment.

“When a patient with hairy cell leukemia begins to experience significant low blood cells, an enlarged spleen, fever, weight loss, or night sweats, it means the patient needs treatment. The first line of treatment is chemotherapy. Chemotherapy kills cancer cells or stops them. A growing therapy, there are now a variety of chemotherapy drugs on the market, and the attending doctor will choose the most suitable chemotherapy drug to treat hairy cell leukemia.”

When patients receive chemotherapy, they are more likely than normal to get sick from infections. Therefore, it is important to wash your hands frequently and stay away from people who are sick. If a patient has a fever, please inform the attending physician or nurse immediately.

Immunotherapy as second-line treatment

He said that once chemotherapy is ineffective or hairy cell leukemia relapses, doctors can try to increase the frequency of chemotherapy, increase the dose of chemotherapy drugs, or change chemotherapy drugs. In addition, immunotherapy is also one of the treatments for hairy cell leukemia. This therapy kills cancer cells by identifying proteins on cancer cells.

Immunotherapy is the second-line treatment for hairy cell leukemia. He will use chemotherapy as the first-line treatment. If the patient shows signs of recurrence, immunotherapy will be used.

“The recurrence rate of hairy cell leukemia is about 10%. Although the recurrence rate is low,

However, it takes 10 years or more to observe and track the condition.

The treatment period depends on the stage of the patient and the chemotherapy regimen.

As long as the condition does not worsen, the 5-year survival rate can reach 90%.“

He noted that if hairy cell leukemia still causes pain or swelling in the spleen after chemotherapy, patients may choose to have their spleen removed. Although removing the spleen does not cure hairy cell leukemia, normal blood counts can usually be restored. Splenectomy is not commonly used to treat hairy cell leukemia, but it may be helpful in some cases.

Interferon α relieves symptoms with short-lasting efficacy

Treatment drugs for hairy cell leukemia include interferon alfa (IFN-α). This drug can restore red blood cells to normal in some patients and relieve the symptoms of the disease, but the effect is short-lived.

Mohd pointed out that after treatment, doctors will check whether there are signs of recurrence of hairy cell leukemia from time to time. They will discuss the patient’s treatment progress with other doctors later, and sometimes arrange physical examinations, blood tests or bone marrow biopsies.

Food poisoning causes low immunity

“Hairy cell leukemia is a rare disease. The abnormal parts can be known through blood tests. Further clinical examination, spleen screening, bone marrow biopsy, etc. can be diagnosed early, and the most correct treatment plan can be received as early as possible. Patients If you receive early treatment, reduce the side effects of chemotherapy, maintain a healthy diet and daily routine, you can live a normal life.”

He said that patients need to take into account a healthy diet and avoid food poisoning, because food poisoning can cause weakness, reduced immunity, and in severe cases, kidney or liver failure. At this time, the patient needs to take antibiotics and inform the attending doctor of his physical condition.

Even after treatment, patients should pay close attention to whether there are still symptoms of hairy cell leukemia to prevent recurrence. Therefore, if you have any symptoms of discomfort, please inform your doctor.

“In addition, patients should also follow medical advice and instructions and discuss more side effects during treatment with their doctors. These two points are very important.”

Receiving treatment for hairy cell leukemia involves many “choices” such as which treatment to receive and how long to receive it. Therefore, before receiving treatment, patients need to ask their doctor:

◆What are the benefits of this treatment? Could it possibly help extend life?

◆What symptoms will it reduce or prevent?

◆What are the disadvantages of this treatment?

◆Are there any other options besides this treatment?

◆What will happen if I don’t receive this treatment?

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