Immunotherapy

Hairy Cell Leukemia

Hairy cell leukemia is a rare type of leukemia that is a cancer of the blood and bone marrow, which is the soft tissue in the center of most bones. It gets its name from the “hairy” appearance its cells have when viewed under a microscope. In hairy cell leukemia, too many blood stem cells become lymphocytes, which are white blood cells that help fight infections. However, these lymphocytes are abnormal and do not become healthy white blood cells. They also are called leukemia cells. The leukemia cells can build up in the blood and bone marrow so there is less room for healthy white blood cells, red blood cells and platelets. This may cause infection, anemia and easy bleeding. Some of the leukemia cells may collect in the spleen and cause it to swell.

Standard treatment options for hairy cell leukemia include watchful waiting, chemotherapy, surgery, targeted therapy and immunotherapy. One type of immunotherapy has been approved for hairy cell leukemia. It is considered a biologic response modifier (BRM), which stimulates the immune system to indirectly affect tumors. For hairy cell leukemia, the approved BRM is a cytokine, which is a protein that enables cells to send messages to each other. Typically the cytokines used for hairy cell leukemia are interferons.

Alpha interferon was approved in 1986 and represented a new and exciting advance in the treatment of hairy cell leukemia. Until that time, splenectomy, or the removal of the spleen, was the only known effective therapy for this disease. Interferon benefited people with active hairy cell leukemia, regardless of whether they had a splenectomy. At the present time, interferon has a relatively limited role in the treatment of hairy cell leukemia, so discuss with your doctor if it is appropriate for you.

New types of treatment are being tested in clinical trials. Although immunotherapy is not a first-line therapy for hairy cell leukemia, clinical trial research is investigating immunoconjugates, BRAF inhibitors and B-cell receptor inhibitors. These options have shown some benefits in people with hairy cell leukemia, but they’ve been studied only for hairy cell leukemia that has come back after or not responded to treatment and only in a small number of people. Clinical trials offer people the opportunity to try these therapies that may be very beneficial for their type and stage of cancer. Talk to your doctor about all of your treatment options and ask if a clinical trial may be the best option for you.

 

FDA-Approved Immunotherapies for Hairy Cell Leukemia
As of 10/26/2016
interferon alfa-2b (Intron A)

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