Biology and Treatment of Hairy Cell Leukemia.

Opinion Statement: Despite its rarity, hairy cell leukemia (HCL) remains a fascinating disease and the physiopathology is becoming more and more understood. The accurate diagnosis of HCL relies on the recognition of hairy cells by morphology and flow cytometry (FCM) in the blood and/or bone marrow (...

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Publicado en:Current Treatment Options in Oncology Vol. 21; no. 6; pp. 1 - 15
Autores principales: Paillassa, Jérôme, Troussard, Xavier
Formato: review Journal Article
Publicado: Springer Nature Jun2020
Acceso en línea:Ver este registro en EBSCOhost
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      pub: Springer Nature
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        10.1007/s11864-020-00732-0
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        atl: Biology and Treatment of Hairy Cell Leukemia.
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        au:
          Paillassa, Jérôme
          Troussard, Xavier
        affil: Department of Hematology, Academic Hospital of Angers, Angers, Pays de la Loire, France
      sug:
        subj:
          Leukemia Therapy
          Leukemia Etiology
          Immunophenotyping
          Disease Management
          Signal Transduction
          Animals
          Bone Marrow Pathology
          Outcomes (Health Care)
          Leukemia Diagnosis
          Disease Progression
          Combined Modality Therapy Methods
          Treatment Outcomes
          Repeat Procedures
          Disease Susceptibility
          Histocytochemistry
          Biopsy
          Leukemia Mortality
          Mutation
          Scales
      ab: Opinion Statement: Despite its rarity, hairy cell leukemia (HCL) remains a fascinating disease and the physiopathology is becoming more and more understood. The accurate diagnosis of HCL relies on the recognition of hairy cells by morphology and flow cytometry (FCM) in the blood and/or bone marrow (BM). The BRAF V600E mutation, an HCL-defining mutation, represents a novel diagnostic parameter and a potential therapeutic target. The precise cellular origin of HCL is a late-activated postgerminal center memory B cell. BRAF mutations were detected in hematopoietic stem cells (HSCs) of patients with HCL, suggesting that this is an early HCL-defining event. Watch-and-wait strategy is necessary in approximately 10% of asymptomatic HCL patients, sometimes for several years. Purine analogs (PNAs) are the established first-line options for symptomatic HCL patients. In second-line treatment, chemoimmunotherapy combining PNA plus rituximab should be considered in high-risk HCL patients. The three options for relapsed/refractory HCL patients include recombinant immunoconjugates targeting CD22, BRAF inhibitors, and BCR inhibitors. The clinical interest to investigate blood minimal residual disease (MRD) was recently demonstrated, with a high risk of relapse in patients with positive testing for MRD and a low risk in patients with negative testing. However, efforts must be made to standardize MRD analyses in the near future. Patients with HCL are at risk of second malignancies. The increased risk could be related to the disease and/or the treatment, and the respective role of PNAs in the development of secondary malignancies remains a topic of debate.
      pubtype: Academic Journal
      doctype:
        review
        Journal Article
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    language: English
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