Treatment if hairy cell leukaemia comes back | Cancer Research UK
Cancer Research UK on Google+ Cancer Research UK on Facebook Cancer Research UK on Twitter

Treatment if hairy cell leukaemia comes back

Men and women discussing hairy cell leukaemia

This page tells you about the treatment for hairy cell leukaemia (HCL) that comes back after earlier treatment. Doctors call this second line treatment. There is information about

 

A quick guide to what's on this page

Treatment if hairy cell leukaemia comes back

If your hairy cell leukaemia (HCL) comes back after earlier treatment, you will have what doctors call second line treatment. Most people have chemotherapy with either cladribine or pentostatin as a first treatment. The second line treatment you have will depend on the time since your last treatment, and 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 may have a different drug.

As well as the chemotherapy your doctor may suggest giving 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, including hairy cell leukaemia cells. The protein is called CD20. Once it has found the CD20 positive cells, rituximab sticks to them. This helps other immune system cells to find them and kill them.

If you are not well enough to have chemotherapy or rituximab your doctor may suggest that you have interferon. Interferon is a type of biological therapy that helps the immune system to destroy the leukaemia cells.

 

CR PDF Icon You can view and print the quick guides for all the pages in the Treating hairy cell leukaemia section.

 

Chemotherapy

Most people have chemotherapy as a first treatment for hairy cell leukaemia (HCL), with either cladribine or pentostatin. If your HCL comes back, you have what doctors call second line treatment. The second line treatment will depend on the time since your last treatment, and 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 may have a different drug. This means that if you had cladribine treatment the first time, you might have pentostatin the second time.

You can find out about cladribine and pentostatin and their possible side effects on the chemotherapy for hairy cell leukaemia page.

 

Rituximab (Mabthera)

As well as the chemotherapy your doctor may suggest giving 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, including hairy cell leukaemia cells. The protein is called CD20. Once it has found the CD20 positive cells, rituximab sticks to them. This helps other immune system cells to find them and kill them.

Rituximab does have some side effects and they are most likely to occur when you first have the drug. You may have 

  • High temperatures (fever), chills and shivering
  • Nausea (feeling sick)
  • An itchy rash
  • Headaches

Your doctor may prescribe you a steroid and antihistamine to try to prevent some of these side effects. A few people have wheezing and feel faint because their blood pressure drops. You are most likely to have one or more of these side effects in the first 2 hours after having the drug. If you do have a reaction, your nurse may slow down your rituximab drip to help control it.

We have detailed information about the side effects of rituximab.

 

Interferon

Your doctor may suggest that you have interferon if you are not well enough to have chemotherapy or rituximab. Interferon is a natural substance that our bodies produce as part of our immune response. Interferon works by helping to stop the leukaemia cells growing. It may also encourage the immune system to attack the cancer. You have it as an injection just under the skin, usually 3 times a week for a year.

The main side effects are flu symptoms during the first week or two of treatment. Interferon can also make you feel sick, lose your appetite, or feel very tired. We have detailed information about interferon and the possible side effects. 

Rate this page:
Submit rating

 

Rated 5 out of 5 based on 6 votes
Rate this page
Rate this page for no comments box
Please enter feedback to continue submitting
Send feedback
Question about cancer? Contact our information nurse team

No Error

Updated: 14 April 2015