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__NOTOC__
{{Hairy cell leukemia}}
{{Hairy cell leukemia}}
{{CMG}}
{{CMG}}; {{AE}} {{HL}}; {{GRR}} {{Nat}}


==Overview==
==Overview==
Hairy cell leukemia is commonly diagnosed after a routine blood count shows unexpectedly low numbers for one or more kinds of blood cells, or after unexplained bruises or unexplained infections, such as repeated bouts of pneumonia in an otherwise apparently healthy patient.
Laboratory findings consistent with the diagnosis of [[hairy cell leukemia]] include abnormal [[complete blood count]], [[immunohistochemistry]], and [[flow cytometry]]. The presence of hairy cells with thread-like [[cytoplasmic]] extensions on blood smear is a key diagnostic feature among patients with hairy cell leukemia.


==Laboratory Tests==
==Laboratory Findings==
Platelet function may be somewhat impaired in HCL patients, although this does not appear to have any significant practical effect.<ref name="pmid512041">{{cite journal |author=Zuzel M, Cawley JC, Paton RC, Burns GF, McNicol GP |title=Platelet function in hairy-cell leukaemia |journal=J. Clin. Pathol. |volume=32 |issue=8 |pages=814-21 |year=1979 |pmid=512041 |doi=}}</ref> 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.  
Laboratory findings consistent with the diagnosis of [[hairy cell leukemia]] include:<ref name="GreverAbdel-Wahab20174">{{cite journal|last1=Grever|first1=Michael R.|last2=Abdel-Wahab|first2=Omar|last3=Andritsos|first3=Leslie A.|last4=Banerji|first4=Versha|last5=Barrientos|first5=Jacqueline|last6=Blachly|first6=James S.|last7=Call|first7=Timothy G.|last8=Catovsky|first8=Daniel|last9=Dearden|first9=Claire|last10=Demeter|first10=Judit|last11=Else|first11=Monica|last12=Forconi|first12=Francesco|last13=Gozzetti|first13=Alessandro|last14=Ho|first14=Anthony D.|last15=Johnston|first15=James B.|last16=Jones|first16=Jeffrey|last17=Juliusson|first17=Gunnar|last18=Kraut|first18=Eric|last19=Kreitman|first19=Robert J.|last20=Larratt|first20=Loree|last21=Lauria|first21=Francesco|last22=Lozanski|first22=Gerard|last23=Montserrat|first23=Emili|last24=Parikh|first24=Sameer A.|last25=Park|first25=Jae H.|last26=Polliack|first26=Aaron|last27=Quest|first27=Graeme R.|last28=Rai|first28=Kanti R.|last29=Ravandi|first29=Farhad|last30=Robak|first30=Tadeusz|last31=Saven|first31=Alan|last32=Seymour|first32=John F.|last33=Tadmor|first33=Tamar|last34=Tallman|first34=Martin S.|last35=Tam|first35=Constantine|last36=Tiacci|first36=Enrico|last37=Troussard|first37=Xavier|last38=Zent|first38=Clive S.|last39=Zenz|first39=Thorsten|last40=Zinzani|first40=Pier Luigi|last41=Falini|first41=Brunangelo|title=Consensus guidelines for the diagnosis and management of patients with classic hairy cell leukemia|journal=Blood|volume=129|issue=5|year=2017|pages=553–560|issn=0006-4971|doi=10.1182/blood-2016-01-689422}}</ref><ref name="pmid7519510">{{cite journal |vauthors=Frassoldati A, Lamparelli T, Federico M, Annino L, Capnist G, Pagnucco G, Dini E, Resegotti L, Damasio EE, Silingardi V |title=Hairy cell leukemia: a clinical review based on 725 cases of the Italian Cooperative Group (ICGHCL). Italian Cooperative Group for Hairy Cell Leukemia |journal=Leuk. Lymphoma |volume=13 |issue=3-4 |pages=307–16 |date=April 1994 |pmid=7519510 |doi=10.3109/10428199409056295 |url=}}</ref><ref name="pmid717940">{{cite journal |vauthors=Golomb HM, Catovsky D, Golde DW |title=Hairy cell leukemia: a clinical review based on 71 cases |journal=Ann. Intern. Med. |volume=89 |issue=5 Pt 1 |pages=677–83 |date=November 1978 |pmid=717940 |doi= |url=}}</ref><ref name="pmid21504285">{{cite journal |vauthors=Kraut E |title=Infectious complications in hairy cell leukemia |journal=Leuk. Lymphoma |volume=52 Suppl 2 |issue= |pages=50–2 |date=June 2011 |pmid=21504285 |doi=10.3109/10428194.2011.570819 |url=}}</ref><ref name="pmid6733679">{{cite journal |vauthors=Westbrook CA, Groopman JE, Golde DW |title=Hairy cell leukemia. Disease pattern and prognosis |journal=Cancer |volume=54 |issue=3 |pages=500–6 |date=August 1984 |pmid=6733679 |doi= |url=}}</ref>


Patients with a high tumor burden may also have somewhat reduced levels of cholesterol,<ref>{{cite web |url=http://www3.interscience.wiley.com/cgi-bin/abstract/50446/ABSTRACT?CRETRY=1&SRETRY=0 |title=wiley.com |accessdate=2007-09-07 |format= |work=}}</ref> especially in patients with an enlarged spleen.<ref>{{cite web |url=http://www.bmj.com/cgi/content/full/311/6996/27 |title=Mechanisms behind hypocholesterolaemia in hairy cell leukaemia -- Juliusson et al. 311 (6996): 27 -- BMJ |accessdate=2007-09-07 |format= |work=}}</ref>  Cholesterol levels return to more normal values with successful treatment of HCL.
=== Complete Blood Count ===
* [[Anemia]] - Decreased [[hemoglobin]] concentration<ref name="pub">{{cite journal |vauthors=Somasundaram V, Purohit A, Aggarwal M, Manivannan P, Mishra P, Seth T, Tyagi S, Mahapatra M, Pati HP, Saxena R |title=Hairy cell leukemia: A decade long experience of North Indian Hematology Center |journal=Indian J Med Paediatr Oncol |volume=35 |issue=4 |pages=271–5 |year=2014 |pmid=25538404 |pmc=4264273 |doi=10.4103/0971-5851.144988 |url=}}</ref>
* [[Thrombocytopenia]] - Decreased [[platelets]] count
* Decreased [[WBC]] count
* [[Neutropenia]]
* Elevated [[Blood urea nitrogen|BUN]] (Blood urea nitrogen)
* Abnormal [[liver function tests]]
* [[Hypergammaglobulinemia]] may be positive in small percentage of patients with [[hairy cell leukemia]]
* [[Leukocytosis]]
* [[Monocytopenia]]  


===Blood Smear===
* Hairy cells with thread-like [[cytoplasmic]] extensions<ref name="GreverAbdel-Wahab20173">{{cite journal|last1=Grever|first1=Michael R.|last2=Abdel-Wahab|first2=Omar|last3=Andritsos|first3=Leslie A.|last4=Banerji|first4=Versha|last5=Barrientos|first5=Jacqueline|last6=Blachly|first6=James S.|last7=Call|first7=Timothy G.|last8=Catovsky|first8=Daniel|last9=Dearden|first9=Claire|last10=Demeter|first10=Judit|last11=Else|first11=Monica|last12=Forconi|first12=Francesco|last13=Gozzetti|first13=Alessandro|last14=Ho|first14=Anthony D.|last15=Johnston|first15=James B.|last16=Jones|first16=Jeffrey|last17=Juliusson|first17=Gunnar|last18=Kraut|first18=Eric|last19=Kreitman|first19=Robert J.|last20=Larratt|first20=Loree|last21=Lauria|first21=Francesco|last22=Lozanski|first22=Gerard|last23=Montserrat|first23=Emili|last24=Parikh|first24=Sameer A.|last25=Park|first25=Jae H.|last26=Polliack|first26=Aaron|last27=Quest|first27=Graeme R.|last28=Rai|first28=Kanti R.|last29=Ravandi|first29=Farhad|last30=Robak|first30=Tadeusz|last31=Saven|first31=Alan|last32=Seymour|first32=John F.|last33=Tadmor|first33=Tamar|last34=Tallman|first34=Martin S.|last35=Tam|first35=Constantine|last36=Tiacci|first36=Enrico|last37=Troussard|first37=Xavier|last38=Zent|first38=Clive S.|last39=Zenz|first39=Thorsten|last40=Zinzani|first40=Pier Luigi|last41=Falini|first41=Brunangelo|title=Consensus guidelines for the diagnosis and management of patients with classic hairy cell leukemia|journal=Blood|volume=129|issue=5|year=2017|pages=553–560|issn=0006-4971|doi=10.1182/blood-2016-01-689422}}</ref><ref name="pmid356959">{{cite journal |vauthors=Golomb HM |title=Hairy cell leukemia: an unusual lymphoproliferative disease: a study of 24 patients |journal=Cancer |volume=42 |issue=2 Suppl |pages=946–56 |date=August 1978 |pmid=356959 |doi= |url=}}</ref>
* Positive [[TRAP1|TRAP]] stain<ref name="pmid6270794">{{cite journal |vauthors=Bernadou A, Pelletier G, Cadiou M, Giannoni F, James JM, Bilski-Pasquier G |title=[Hairy cell leukemia. I.--Clinical, biological and evolutive study on twenty-eight cases (author's transl)] |language=French |journal=Sem Hop |volume=57 |issue=33-36 |pages=1361–5 |date=1981 |pmid=6270794 |doi= |url=}}</ref>
===Immunohistochemistry and Flow Cytometry===
* On immunohistochemistry and flow cytometry, characteristic findings of hairy cell leukemia include:<ref name="ShermanHanson20112">{{cite journal|last1=Sherman|first1=Michael J.|last2=Hanson|first2=Curtis A.|last3=Hoyer|first3=James D.|title=An Assessment of the Usefulness of Immunohistochemical Stains in the Diagnosis of Hairy Cell Leukemia|journal=American Journal of Clinical Pathology|volume=136|issue=3|year=2011|pages=390–399|issn=1943-7722|doi=10.1309/AJCP5GE1PSBMBZTW}}</ref><ref name="GreverAbdel-Wahab20172">{{cite journal|last1=Grever|first1=Michael R.|last2=Abdel-Wahab|first2=Omar|last3=Andritsos|first3=Leslie A.|last4=Banerji|first4=Versha|last5=Barrientos|first5=Jacqueline|last6=Blachly|first6=James S.|last7=Call|first7=Timothy G.|last8=Catovsky|first8=Daniel|last9=Dearden|first9=Claire|last10=Demeter|first10=Judit|last11=Else|first11=Monica|last12=Forconi|first12=Francesco|last13=Gozzetti|first13=Alessandro|last14=Ho|first14=Anthony D.|last15=Johnston|first15=James B.|last16=Jones|first16=Jeffrey|last17=Juliusson|first17=Gunnar|last18=Kraut|first18=Eric|last19=Kreitman|first19=Robert J.|last20=Larratt|first20=Loree|last21=Lauria|first21=Francesco|last22=Lozanski|first22=Gerard|last23=Montserrat|first23=Emili|last24=Parikh|first24=Sameer A.|last25=Park|first25=Jae H.|last26=Polliack|first26=Aaron|last27=Quest|first27=Graeme R.|last28=Rai|first28=Kanti R.|last29=Ravandi|first29=Farhad|last30=Robak|first30=Tadeusz|last31=Saven|first31=Alan|last32=Seymour|first32=John F.|last33=Tadmor|first33=Tamar|last34=Tallman|first34=Martin S.|last35=Tam|first35=Constantine|last36=Tiacci|first36=Enrico|last37=Troussard|first37=Xavier|last38=Zent|first38=Clive S.|last39=Zenz|first39=Thorsten|last40=Zinzani|first40=Pier Luigi|last41=Falini|first41=Brunangelo|title=Consensus guidelines for the diagnosis and management of patients with classic hairy cell leukemia|journal=Blood|volume=129|issue=5|year=2017|pages=553–560|issn=0006-4971|doi=10.1182/blood-2016-01-689422}}</ref><ref name="VenkataramanAguhar2011">{{cite journal|last1=Venkataraman|first1=Girish|last2=Aguhar|first2=Christine|last3=Kreitman|first3=Robert J.|last4=Yuan|first4=Constance M.|last5=Stetler-Stevenson|first5=Maryalice|title=Characteristic CD103 and CD123 Expression Pattern Defines Hairy Cell Leukemia|journal=American Journal of Clinical Pathology|volume=136|issue=4|year=2011|pages=625–630|issn=1943-7722|doi=10.1309/AJCPKUM9J4IXCWEU}}</ref><ref name="pmid15183626">{{cite journal |vauthors=Falini B, Tiacci E, Liso A, Basso K, Sabattini E, Pacini R, Foa R, Pulsoni A, Dalla Favera R, Pileri S |title=Simple diagnostic assay for hairy cell leukaemia by immunocytochemical detection of annexin A1 (ANXA1) |journal=Lancet |volume=363 |issue=9424 |pages=1869–70 |date=June 2004 |pmid=15183626 |doi=10.1016/S0140-6736(04)16356-3 |url=}}</ref>
** [[Annexin A1]] +ve
** VE1+ve(a BRAFV600E stain)<ref name="UppalLy2015">{{cite journal|last1=Uppal|first1=Guldeep|last2=Ly|first2=Vandi|last3=Wang|first3=Zi-Xuan|last4=Bajaj|first4=Renu|last5=Solomides|first5=Charalambos C.|last6=Banks|first6=Peter M.|last7=Medeiros|first7=L. Jeffrey|last8=Peiper|first8=Stephen C.|last9=Gong|first9=Jerald Z.|title=The Utility of BRAF V600E Mutation-Specific Antibody VE1 for the Diagnosis of Hairy Cell Leukemia|journal=American Journal of Clinical Pathology|volume=143|issue=1|year=2015|pages=120–125|issn=1943-7722|doi=10.1309/AJCPQLQ89VXTVWKN}}</ref><ref name="pmid22531170">{{cite journal |vauthors=Andrulis M, Penzel R, Weichert W, von Deimling A, Capper D |title=Application of a BRAF V600E mutation-specific antibody for the diagnosis of hairy cell leukemia |journal=Am. J. Surg. Pathol. |volume=36 |issue=12 |pages=1796–800 |date=December 2012 |pmid=22531170 |doi=10.1097/PAS.0b013e3182549b50 |url=}}</ref><ref name="pmid25120816">{{cite journal |vauthors=Wang XJ, Kim A, Li S |title=Immunohistochemical analysis using a BRAF V600E mutation specific antibody is highly sensitive and specific for the diagnosis of hairy cell leukemia |journal=Int J Clin Exp Pathol |volume=7 |issue=7 |pages=4323–8 |date=2014 |pmid=25120816 |pmc=4129051 |doi= |url=}}</ref>
** T-bet+ve
** [[CD20]] +ve
** [[CD25]] +ve
** [[CD103]] +ve
** CD123 +ve
** [[CD19]] +ve
** [[CD11c]] +ve
** [[FMC7]] +ve
==References==
==References==
{{reflist|2}}
{{reflist|2}}
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Latest revision as of 17:23, 8 April 2019

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Haytham Allaham, M.D. [2]; Grammar Reviewer: Natalie Harpenau, B.S.[3]

Overview

Laboratory findings consistent with the diagnosis of hairy cell leukemia include abnormal complete blood count, immunohistochemistry, and flow cytometry. The presence of hairy cells with thread-like cytoplasmic extensions on blood smear is a key diagnostic feature among patients with hairy cell leukemia.

Laboratory Findings

Laboratory findings consistent with the diagnosis of hairy cell leukemia include:[1][2][3][4][5]

Complete Blood Count

Blood Smear

Immunohistochemistry and Flow Cytometry

References

  1. ↑ Grever, Michael R.; Abdel-Wahab, Omar; Andritsos, Leslie A.; Banerji, Versha; Barrientos, Jacqueline; Blachly, James S.; Call, Timothy G.; Catovsky, Daniel; Dearden, Claire; Demeter, Judit; Else, Monica; Forconi, Francesco; Gozzetti, Alessandro; Ho, Anthony D.; Johnston, James B.; Jones, Jeffrey; Juliusson, Gunnar; Kraut, Eric; Kreitman, Robert J.; Larratt, Loree; Lauria, Francesco; Lozanski, Gerard; Montserrat, Emili; Parikh, Sameer A.; Park, Jae H.; Polliack, Aaron; Quest, Graeme R.; Rai, Kanti R.; Ravandi, Farhad; Robak, Tadeusz; Saven, Alan; Seymour, John F.; Tadmor, Tamar; Tallman, Martin S.; Tam, Constantine; Tiacci, Enrico; Troussard, Xavier; Zent, Clive S.; Zenz, Thorsten; Zinzani, Pier Luigi; Falini, Brunangelo (2017). "Consensus guidelines for the diagnosis and management of patients with classic hairy cell leukemia". Blood. 129 (5): 553–560. doi:10.1182/blood-2016-01-689422. ISSN 0006-4971.
  2. ↑ Frassoldati A, Lamparelli T, Federico M, Annino L, Capnist G, Pagnucco G, Dini E, Resegotti L, Damasio EE, Silingardi V (April 1994). "Hairy cell leukemia: a clinical review based on 725 cases of the Italian Cooperative Group (ICGHCL). Italian Cooperative Group for Hairy Cell Leukemia". Leuk. Lymphoma. 13 (3–4): 307–16. doi:10.3109/10428199409056295. PMID 7519510.
  3. ↑ Golomb HM, Catovsky D, Golde DW (November 1978). "Hairy cell leukemia: a clinical review based on 71 cases". Ann. Intern. Med. 89 (5 Pt 1): 677–83. PMID 717940.
  4. ↑ Kraut E (June 2011). "Infectious complications in hairy cell leukemia". Leuk. Lymphoma. 52 Suppl 2: 50–2. doi:10.3109/10428194.2011.570819. PMID 21504285.
  5. ↑ Westbrook CA, Groopman JE, Golde DW (August 1984). "Hairy cell leukemia. Disease pattern and prognosis". Cancer. 54 (3): 500–6. PMID 6733679.
  6. ↑ Somasundaram V, Purohit A, Aggarwal M, Manivannan P, Mishra P, Seth T, Tyagi S, Mahapatra M, Pati HP, Saxena R (2014). "Hairy cell leukemia: A decade long experience of North Indian Hematology Center". Indian J Med Paediatr Oncol. 35 (4): 271–5. doi:10.4103/0971-5851.144988. PMC 4264273. PMID 25538404.
  7. ↑ Grever, Michael R.; Abdel-Wahab, Omar; Andritsos, Leslie A.; Banerji, Versha; Barrientos, Jacqueline; Blachly, James S.; Call, Timothy G.; Catovsky, Daniel; Dearden, Claire; Demeter, Judit; Else, Monica; Forconi, Francesco; Gozzetti, Alessandro; Ho, Anthony D.; Johnston, James B.; Jones, Jeffrey; Juliusson, Gunnar; Kraut, Eric; Kreitman, Robert J.; Larratt, Loree; Lauria, Francesco; Lozanski, Gerard; Montserrat, Emili; Parikh, Sameer A.; Park, Jae H.; Polliack, Aaron; Quest, Graeme R.; Rai, Kanti R.; Ravandi, Farhad; Robak, Tadeusz; Saven, Alan; Seymour, John F.; Tadmor, Tamar; Tallman, Martin S.; Tam, Constantine; Tiacci, Enrico; Troussard, Xavier; Zent, Clive S.; Zenz, Thorsten; Zinzani, Pier Luigi; Falini, Brunangelo (2017). "Consensus guidelines for the diagnosis and management of patients with classic hairy cell leukemia". Blood. 129 (5): 553–560. doi:10.1182/blood-2016-01-689422. ISSN 0006-4971.
  8. ↑ Golomb HM (August 1978). "Hairy cell leukemia: an unusual lymphoproliferative disease: a study of 24 patients". Cancer. 42 (2 Suppl): 946–56. PMID 356959.
  9. ↑ Bernadou A, Pelletier G, Cadiou M, Giannoni F, James JM, Bilski-Pasquier G (1981). "[Hairy cell leukemia. I.--Clinical, biological and evolutive study on twenty-eight cases (author's transl)]". Sem Hop (in French). 57 (33–36): 1361–5. PMID 6270794.
  10. ↑ Sherman, Michael J.; Hanson, Curtis A.; Hoyer, James D. (2011). "An Assessment of the Usefulness of Immunohistochemical Stains in the Diagnosis of Hairy Cell Leukemia". American Journal of Clinical Pathology. 136 (3): 390–399. doi:10.1309/AJCP5GE1PSBMBZTW. ISSN 1943-7722.
  11. ↑ Grever, Michael R.; Abdel-Wahab, Omar; Andritsos, Leslie A.; Banerji, Versha; Barrientos, Jacqueline; Blachly, James S.; Call, Timothy G.; Catovsky, Daniel; Dearden, Claire; Demeter, Judit; Else, Monica; Forconi, Francesco; Gozzetti, Alessandro; Ho, Anthony D.; Johnston, James B.; Jones, Jeffrey; Juliusson, Gunnar; Kraut, Eric; Kreitman, Robert J.; Larratt, Loree; Lauria, Francesco; Lozanski, Gerard; Montserrat, Emili; Parikh, Sameer A.; Park, Jae H.; Polliack, Aaron; Quest, Graeme R.; Rai, Kanti R.; Ravandi, Farhad; Robak, Tadeusz; Saven, Alan; Seymour, John F.; Tadmor, Tamar; Tallman, Martin S.; Tam, Constantine; Tiacci, Enrico; Troussard, Xavier; Zent, Clive S.; Zenz, Thorsten; Zinzani, Pier Luigi; Falini, Brunangelo (2017). "Consensus guidelines for the diagnosis and management of patients with classic hairy cell leukemia". Blood. 129 (5): 553–560. doi:10.1182/blood-2016-01-689422. ISSN 0006-4971.
  12. ↑ Venkataraman, Girish; Aguhar, Christine; Kreitman, Robert J.; Yuan, Constance M.; Stetler-Stevenson, Maryalice (2011). "Characteristic CD103 and CD123 Expression Pattern Defines Hairy Cell Leukemia". American Journal of Clinical Pathology. 136 (4): 625–630. doi:10.1309/AJCPKUM9J4IXCWEU. ISSN 1943-7722.
  13. ↑ Falini B, Tiacci E, Liso A, Basso K, Sabattini E, Pacini R, Foa R, Pulsoni A, Dalla Favera R, Pileri S (June 2004). "Simple diagnostic assay for hairy cell leukaemia by immunocytochemical detection of annexin A1 (ANXA1)". Lancet. 363 (9424): 1869–70. doi:10.1016/S0140-6736(04)16356-3. PMID 15183626.
  14. ↑ Uppal, Guldeep; Ly, Vandi; Wang, Zi-Xuan; Bajaj, Renu; Solomides, Charalambos C.; Banks, Peter M.; Medeiros, L. Jeffrey; Peiper, Stephen C.; Gong, Jerald Z. (2015). "The Utility of BRAF V600E Mutation-Specific Antibody VE1 for the Diagnosis of Hairy Cell Leukemia". American Journal of Clinical Pathology. 143 (1): 120–125. doi:10.1309/AJCPQLQ89VXTVWKN. ISSN 1943-7722.
  15. ↑ Andrulis M, Penzel R, Weichert W, von Deimling A, Capper D (December 2012). "Application of a BRAF V600E mutation-specific antibody for the diagnosis of hairy cell leukemia". Am. J. Surg. Pathol. 36 (12): 1796–800. doi:10.1097/PAS.0b013e3182549b50. PMID 22531170.
  16. ↑ Wang XJ, Kim A, Li S (2014). "Immunohistochemical analysis using a BRAF V600E mutation specific antibody is highly sensitive and specific for the diagnosis of hairy cell leukemia". Int J Clin Exp Pathol. 7 (7): 4323–8. PMC 4129051. PMID 25120816.


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