Monday, November 28, 2011

Hairy Cell Leukemia

Hairy Cell leukemia is a rare blood cancer.  This cancer is seen more in men that women and most often middle age to senior age adults. HCL is a slow growing leukemia and it affects the B-cells,lymphocytes, in the bone marrow.
Below is image of what HCL looks like under the microscope.

What are the symptoms of HCL?
You will notice that the white cells, lymphocytes, are larger than normal lymphocytes.  Also, notice the hair-like projections on the edge of the cytoplasm.

In hairy cell leukemia, the "hairy cells" (malignant B lymphocytes) accumulate in the bone marrow, interfering with the production of normal white blood cells, red blood cells, and platelets. Consequently, patients may develop infections related to low white blood cell count, anemia and fatigue due to a lack of red blood cells, or easy bleeding due to a low platelet count.[12] Leukemic cells may gather in the spleen and cause it to swell; this can have the side effect of making the person feel full even when he or she has not eaten much.
Hairy cell leukemia is commonly diagnosed after a routine blood count shows unexpectedly low numbers of one or more kinds of normal blood cells, or after unexplained bruises or recurrent infections in an otherwise apparently healthy patient.
Platelet function may be somewhat impaired in HCL patients, although this does not appear to have any significant practical effect.[13] It may result in somewhat more mild bruises than would otherwise be expected for a given platelet count or a mildly increased bleeding time for a minor cut. It is likely the result of producing slightly abnormal platelets in the overstressed bone marrow tissue.
Patients with a high tumor burden may also have somewhat reduced levels of cholesterol,[14] especially in patients with an enlarged spleen.[15] Cholesterol levels return to more normal values with successful treatment of HCL.

The causes of HCL has determined that persons who farm and garden may have increases risk in getting this cancers. 
The U.S. Institute of Medicine (IOM) announced "sufficient evidence" of an association between exposure to herbicides and later development of chronic B-cell leukemias and lymphomas in general.

Diagnosis for HCL involves the following lab tests.
  Acomplete blood count (CBC), but additional testing is necessary to confirm the diagnosis. A CBC normally shows low counts for white blood cells, red blood cells, and platelets in HCL patients. However, if large numbers of hairy cells in the blood streams ,then normal or high lymphocytes can be found.  Another test is viewing a slide in which a drop of blood has been smeared across the glass and then stained with a Wrights which differentiates the different types of white cells.  HCL appear as the image above.  A bone marrow aspirate is a great tool in the final diagnosis.  The bone marrow is where blood cells are made.  The bone marrow will be stained and viewed under a microscope. The diagnosis can be confirmed by using the stain known as TRAP(tartrate resistant acid phospatase).

Hairy cell leukemia is not curable, but can be easily put into remission for several years.

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