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About chemotherapy

Chemotherapy uses anti cancer (cytotoxic) drugs to destroy cancer cells. The drugs circulate throughout the body in the bloodstream.

Types of chemotherapy

The most commonly used chemotherapy drugs for hairy cell leukaemia are cladribine or pentostatin. 

Cladribine (CDA)

You might have cladribine as an injection just below the skin every day for 5 days in a row.

Some people have cladribine into a vein as a continuous drip (infusion) for 7 days.

There are other ways of having cladribine, including as an infusion over 2 hours for 5 days, or once a week for 6 weeks. Your doctor will talk to you about how you will have it. 

Most people have just one course of cladribine.

Pentostatin

You have pentostatin into a vein every 2 weeks, until all signs of the leukaemia have gone or it is under control. The length of treatment varies from one person to another and depends on how the hairy cell leukaemia responds.

Generally the treatment lasts between 3 to 6 months. Each treatment takes around half an hour.

How you have it

You might have chemotherapy as an injection under your skin (subcutaneous injection), or as a drip into your bloodstream (infusion).

Injection under the skin

You usually have subcutaneous injections into the stomach, thigh or top of your arm.

The video below shows you how to give an injection just under your skin. 

Into your bloodstream

You have the treatment through a drip into your arm. A nurse puts a small tube (a cannula) into one of your veins and connects the drip to it.

Chemotherapy into the bloodstream.jpg

You might need a central line. This is a long plastic tube that gives the drugs into a large vein, either in your chest or through a vein in your arm. It stays in while you’re having treatment, which may be for a few months.

Where you have chemotherapy

If you have cladribine as an injection under your skin, you might go to the hospital day unit for your injections. Or a district nurse can give them to you at home.

Your nurse might teach you to give them yourself.

If you have chemotherapy as a drip into your bloodstream, you usually have this in hospital. You might have this as an inpatient on the ward, or as an outpatient in the cancer day clinic.

Before you start chemotherapy

You need to have blood tests to make sure it’s safe to start treatment. You have these either a few days before or on the day you start treatment. You have blood tests before each round or cycle of treatment.

Side effects

Common side effects include:

  • increased risk of infections
  • feeling very tired (fatigue)
  • bleeding and bruising easily
  • feeling or being sick (nausea and vomiting)
  • a skin rash
Contact the doctor or nurse immediately if you have any signs of infection such as a temperature below 36C or higher than 37.5C, or you are generally feeling unwell. Infections can make you very unwell very quickly.

Side effects depend on:

  • which drug you have
  • how much of the drug you have
  • how you react

Tell your treatment team about any side effects that you have.

When you go home

Chemotherapy for hairy cell leukaemia can be difficult to cope with. Tell your doctor or nurse about any problems or side effects that you have. Your nurse will give you telephone numbers to call if you have any problems at home.

If you have any questions about chemotherapy for hairy cell leukaemia, you can call Cancer Research UK's information nurses on freephone 0808 800 4040, 9am to 5pm, Monday to Friday.
Last reviewed: 
20 Feb 2018
  • Electronic Medicines Compendium
    Accessed February 2018 

  • Hairy cell leukaemia: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up

    T Robak and others 

    Annals of oncology, Volume 26, Supplement 5, pages 100-107 

  • LCA Haemato-Oncology Clinical Guidelines Lymphoid Malignancies Part 5: Less Common Lymphoid Malignancies

    London cancer alliance (2015) 

  • Oncology/Haematology 24 Hour Triage Rapid Assessment and Access Toolkit (version 1.2)
    UK Oncology Nursing Society, December 2016

  • The role of temperature in the detection and diagnosis of neutropenic sepsis in adult solid tumour cancer patients receiving chemotherapy 
    C Warnock
    European Journal of Oncology Nursing, 2018. Volume 37, pages 12 to 18

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