Hairy cell leukaemia research
This page tells you what’s new in hairy cell leukaemia. You can find out about
Hairy cell leukaemia research
All treatments must be fully researched before they can be adopted as standard treatment for everyone. This is so that we can be sure they work better than the treatments we already use. And so we know that they are safe.
Firstly, treatments are developed and tested in laboratories. Only after we know that they are likely to be safe to test are they tested in people, in clinical trials. As hairy cell leukaemia is a rare cancer, it is more difficult to do trials. Talk to your doctor if you are interested in a new treatment and they will be able to tell you if it is appropriate for you. Cancer Research UK supports a lot of UK laboratory research into cancer and also supports many UK and international clinical trials.
You can view and print the quick guides for all the pages in the Treating hairy cell leukaemia section.
We must fully research all potential new treatments before we can adopt them as standard treatment for everyone. This is so that
- We can be sure they work
- We can be sure they work better than the treatments that are available at the moment
- We know they are safe
Firstly, treatments are developed and tested in laboratories. For ethical and safety reasons, experimental treatments must be tested in the laboratory before they can be tried in patients. If a treatment is said to be at the laboratory stage of research, it is not ready for patients and is not available either within or outside the NHS. Cancer Research UK supports a lot of UK laboratory research into cancer.
Tests using patients are called clinical trials. Cancer Research UK supports many UK and international clinical trials.
Our trials and research section has information about what trials are including information about the 4 phases of clinical trials. Hairy cell leukaemia is rare and so it is more difficult to do trials. Talk to your doctor if you are interested in a new treatment and they will be able to tell you if it is appropriate for you. All the new approaches covered here are the subject of ongoing research. Until studies are completed and new effective treatments are found, these potential new treatments cannot be used as standard therapy for hairy cell leukaemia.
Because it is rare, there are fewer clinical trials for hairy cell leukaemia than for more common types of leukaemia. It is hard to organise and run trials for rare conditions and it can take a long time to recruit the number of patients needed. Getting enough patients is critical to the success of a trial. If the trial is too small, the results won't be powerful enough to prove that one type of treatment is any better than any other.
Here is a video on experiences of taking part in a clinical trial:
View a transcript of the video (Opens in a new window)
There is a study looking at the abnormal lymphocyte cells that are found in the blood of people with diseases like hairy cell leukaemia. The researchers want to find out more about the causes of some types of lymphoma and chronic leukaemia. Scientists are trying to understand how a particular gene helps these abnormal cells to survive. You may be asked to give a blood sample to help with this study. It is unlikely to affect your treatment in any way, but the information from the study could help people with hairy cell leukaemia and other types of cancer in the future.
Doctors diagnose hairy cell leukaemia by looking at the blood and bone marrow biopsy under a microscope. These tests use chemical stains to show up different cells. Doctors have recently developed a new way to do this. It is called immunohistochemical (IHC) staining. IHC makes it easier to spot differences between hairy cell leukaemia and other blood diseases. The test can also identify hairy cell leukaemia – variant (HCL-v). It was previously thought that this was a rare type of HCL. The World Health Organisation now recognises HCL-v as a completely different condition. HCL and HCL-v cells look different from each other under a microscope. They have different proteins on their cell surfaces. HCL-v does not respond to standard HCL treatments.
IHC may also be useful in finding any cells that remain after treatment. Doctors call this minimal residual disease (MRD). We know that treating people who have MRD before they have symptoms doesn’t improve their outlook. But learning more about which people with MRD have disease that comes back and which don’t may help doctors know more about how well treatments work.
A small American trial looked at blood samples from 47 people with HCL. The researchers found a genetic change (mutation) called BRAF V600E. The genetic change was found in all the people with HCL, but not in 195 other people with other types of B cell lymphomas and leukaemias. The scientists think that in the future this genetic change may be used to help diagnose and monitor HCL. And it may help doctors make decisions about treatment.
Doctors are researching the use of biological therapy drugs called monoclonal antibodies (MABs) for HCL. MABs are proteins that can recognise specific proteins found on the surface of cancer or leukaemia cells. A toxin (a type of poison) can be attached to a monoclonal antibody. These treatments are called immunotoxins. The antibody attaches itself to the protein on the leukaemia cell and delivers the toxin to the cell. The toxin then kills the cancer cell.
Research in the USA has looked at an immunotoxin called BL22 which targets the protein CD22. This is one of the proteins on the surface of hairy cell leukaemia cells. The research showed that it may be a useful treatment for hairy cell leukaemia. American doctors are also looking at a drug similar to BL22 called moxetumomab pasudotox. A small phase 1 trial showed that this treatment helped people with HCL. But we need more research to find out more about how well these drugs work and what their side effects are.
Researchers have found that some people with hairy cell leukaemia (HCL) have a gene change (mutation) called BRAF V600E. This gene change stimulates the cancer cells to grow. Very early research is looking at a drug called Vemurafenib which aims to block this process and stop the cancer from growing. Researchers want to see if it might help treat people with HCL. There is a very early trial in America looking at Vemurafenib in people who have HCL that has come back or has not responded to treatment. There aren't currently any trials in the UK using Vemurafenib.
You can read more about Vemurafenib and its side effects in our cancer drugs section.
Cladribine is a chemotherapy drug that is used to treat HCL. It may be given as an injection or as a drip (intravenous infusion) continuously for 7 days. Doctors have looked at giving the cladribine drip over a couple of hours, rather than continuously for 7 days. This would mean that you could have your treatment as an outpatient, rather than staying in hospital. In the trials, doctors gave cladribine over 2 hours either
- Daily for 5 days
- Once a week for 6 weeks
A trial that compared these two ways of giving treatments showed that both worked equally as well. And the side effects were similar.
Another trial compared daily treatment with a drip once a week for 5 weeks instead of 6. This also worked equally as well. And the weekly treatment didn’t lower the blood cell counts as much as the daily treatment did. The trials so far have only looked at a small number of people and followed them up for a short time. So we don’t yet know if giving cladribine over a shorter time works well in the long term. Doctors need to do more research with more people before these can become standard ways of giving cladribine.
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