Dr. Kreitman on the Prognosis of Hairy Cell Leukemia

Robert J. Kreitman, MD, chief, Clinical Immunotherapy Section, Laboratory of Molecular Biology, Center for Cancer Research, National Cancer Institute, discusses the prognosis for patients diagnosed with hairy cell leukemia (HCL).

In the early 1970s, the life span of a patient with HCL was about 4 years following diagnosis, says Kreitman. This is the prognosis for patients without effective treatment, but with effective treatment, patients tend to relapse at the point where their blood counts become low. This happens over a median period of about 15 years, Kreitman explains.

Chemotherapy after relapse is not as efficacious, and the toxicity levels are higher. Rituximab (Rituxan) and BRAF inhibitors can be used in this setting, as well as the newly-approved CD22-directed recombinant immunotoxin moxetumomab pasudotox (Lumoxiti). Moxetumomab pasudotox was approved by the FDA in September 2018 for the treatment of adult patients with relapsed or refractory HCL who have received at least 2 prior lines of therapy, including treatment with a purine nucleoside analog.