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Treatment for hairy cell leukaemia that has come back

Read about treatment for hairy cell leukaemia that has come back. This is called second line treatment.


Most people have chemotherapy as a first treatment for hairy cell leukaemia, with either cladribine or pentostatin. The second line treatment depends on: 

  • the time since your last treatment
  • what treatment you have already had

If your last treatment was more than 2 years ago, you might have the same chemotherapy drug again. But if it was less than 2 years, you might have a different drug.

This means that if you had cladribine treatment the first time, you might have pentostatin the second time.

Biological therapy

Biological therapies are drugs that change the way cells work and help the body control the growth of cancer. Some seek out and destroy cancer cells. Others help the body attack the cancer.


As well as chemotherapy, you might have rituximab. Rituximab is a type of biological therapy called a monoclonal antibody. It works by seeking out a protein that is found on some normal and leukaemic white blood cells. The protein is called CD20.

Once it has found the CD20 positive cells, rituximab sticks to them. This helps the immune system to find them and kill them.

You usually have rituximab as a drip (infusion) into your bloodstream.


Your doctor might suggest that you have interferon if you're not well enough to have chemotherapy or rituximab.

Interferon is a natural substance that our bodies produce as part of our immune response. Interferon therapy works by helping to stop the leukaemia cells growing. It might also encourage the immune system to attack the cancer.

You have interferon as an injection just under the skin, usually 3 times a week for a year.

Clinical trials to improve treatment

Your doctor might ask if you’d like to take part in a clinical trial. Doctors and researchers do trials to improve treatment by:

  • making existing treatments better
  • developing new treatments
Last reviewed: 
14 Apr 2015
  • Revised guidelines for the diagnosis and management of hairy cell leukaemia and hairy cell leukaemia variant
    G Jones and others
    British Journal of Haematology, 2012. Volume 156, Issue 2

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