Initial management of hairy cell leukemia

* Either 5 daily infusions of cladribine or 7 days of continuous infusion cladribine can be used. Starting 4 to 6 weeks after initial treatment with cladribine, we offer 4 weekly doses of rituximab consolidation.

¶ Treatment aims to alleviate symptoms and reverse cytopenias. A formal response assessment is delayed until 4 to 6 months after completion of therapy.

Δ Treatment is indicated if the patient develops significant disease-related complications at any time. Most patients can be seen every 3 months for the first year and then every 3 to 6 months. At these visits we perform a history, physical examination, and a complete blood count with differential.

◊ Pentostatin is administered by infusion every 2 weeks. Failure to obtain clinical evidence of an objective response by 6 months should lead to a change in therapy. Patients who show objective evidence of response by 6 months can be treated for up to a year in an attempt to achieve an optimal response.