Hairy cell leukaemia
Prepared with OnCo (onco.cc/prep/hairy-cell-leukemia/). Orientation, not medical advice; your team knows your case.
My details
What I know, what is unclear, changes to discuss
Saved in this browserMy questions
15 on the sheet- 1.What is my exact diagnosis, stage, and grade, and which tests established them?
- 2.Which biomarkers have been tested on my tumour (for example BRAF V600E, Flow cytometry: CD11c, CD25, CD103, CD123, MRD by flow or BRAF ddPCR, IGHV4-34 usage, MAP2K1 mutations), and what were the results?
- 3.Which subtype is my cancer, and does that change the recommended treatment?
- 4.Is germline (inherited) genetic testing recommended for me or my family?
- 5.For my situation (first line, symptomatic), which of the standard options do you recommend and why?
- 6.Am I a candidate for Cladribine, Rituximab, and what side effects should I expect?
- 7.For my situation (relapse after >2 years), which of the standard options do you recommend and why?
- 8.Am I a candidate for Cladribine, Rituximab, and what side effects should I expect?
- 9.For my situation (early relapse or refractory), which of the standard options do you recommend and why?
- 10.Am I a candidate for Vemurafenib, Rituximab, Dabrafenib + trametinib or related drugs, and what side effects should I expect?
- 11.Are there clinical trials I could join, for example of Vemurafenib, Dabrafenib + trametinib?
- 12.Would a second opinion at a high-volume centre change anything, and can you help arrange it?
- 13.What supportive care (symptom control, nutrition, exercise, mental health, financial help) is available from the start?
- 14.I read that “Variant HCL and IGHV4-34 disease respond poorly to purine analogues”. How does that affect my plan?
- 15.I read that “Infection risk during induction neutropenia”. How does that affect my plan?
The words I may hear
- Minimal / molecular residual disease (MRD): Cancer still present after treatment but too small to see on scans, detected by blood or marrow tests.
Tests and results to bring
Biomarker results to ask for: BRAF V600E (IHC VE1, PCR, ddPCR), Flow cytometry: CD11c, CD25, CD103, CD123, MRD by flow or BRAF ddPCR, IGHV4-34 usage, MAP2K1 mutations (variant).
Scans and tests linked to this cancer: Multiparameter flow cytometry MRD.
Bring copies of scan reports, pathology and blood results, and a list of every medicine and supplement.
The treatments I may be offered
- First line, symptomatic: Cladribine (5-7 days) or pentostatin, with rituximab concurrent or delayed (improves MRD-negative CR). (Cladribine, Rituximab)
- Relapse after >2 years: Repeat purine analogue + rituximab. (Cladribine, Rituximab)
- Early relapse or refractory: Vemurafenib + rituximab (or dabrafenib-trametinib); ibrutinib; clinical trial. Moxetumomab pasudotox produced durable remissions but was withdrawn from sale in 2023 and is no longer available. (Vemurafenib, Rituximab, Dabrafenib + trametinib, Ibrutinib, Moxetumomab pasudotox)
From the standard of care recorded for this cancer; which apply depends on your stage and biomarkers. Ask which the team recommends and why.