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How do you approach the treatment of hairy cell leukemia with inadequate response to front line therapy?
If a patient obtains a PR or less to front line cladribine, what factors help you chose between a second course of cladribine, an alternative purine analog, rituximab monotherapy or combination therapy or BRAF-directed therapy with vemurafenib?
Is your choice in above therapy different in the case of variant-HCL?
Answer from: Medical Oncologist at Academic Institution
It is unusual not to achieve an excellent response, usually CR, following initial therapy with a single cycle of Cladribine. I would always make sure that the diagnosis is correct. There are other lymphoproliferative disorders which can be mistaken for hairy cell leukemia (HCL). Whenever I hear of a...
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