Live Hairy Cell Leukemia Discussion

I’m going to try Berci’s trick and live blog an early discussion with Nat and Kenna. 

[10:19]  You: So what is hcl?
[10:19]  Natalie Balogh: Hairy cell leukemia
[10:20]  You: Ya, but what is it?
[10:20]  Kenna McMillan: A chronic leukemia of b cells?
[10:20]  You: differentiated or undifferentiated?
[10:21]  Natalie Balogh: I remember you said last week that it was well differentiated B lymphocytes

[10:23]  Kenna McMillan: Wan’t there something about radiation exposure…like benzene?
[10:23]  You: Yah, good!
[10:23]  Natalie Balogh: It effects mostly men over 50
[10:24]  You: Well…the median age range is 50, yah 

10:29]  You: do you know the clinical features?
[10:29]  Natalie Balogh: Like weakness, splenomegaly?
[10:29]  You: Yah
[10:29]  You: Clinical features and incidences?
[10:30]  Natalie Balogh: I think you mentioned that splenomegaly was like 90% incidence in HCL
[10:30]  You: Good, yah
[10:31]  Kenna McMillan: We know marrow fibrosis is a feature
[10:31]  You: Clinical features, though…like weakness
[10:32]  Natalie Balogh: You said that due to the spleen a lot of pts feel full, bloated?
[10:32]  You: Yes
[10:32]  You: the incidence is about 25% with accompanying weight loss

[11:08]  Natalie Balogh: do patients still have splenectomies performed?
[11:08]  You: Sometimes, but usually it’s avoided if possible
[11:08]  You: we also use interferon alpha MAB
[11:08]  You: it’s known as rituximab
[11:09]  You: It’s successful in 70% of the cases
[11:09]  Natalie Balogh: wow..so it’s highy curable
[11:09]  You: Very much so
[11:09]  You: we use 2 CdA or DCF if treatment is needed most often
[11:10]  You: But like I said, these are highly immunosuppressive
[11:10]  Natalie Balogh: What are the cure rates with those drugs
[11:10]  You: Mmm, about 10% of pt are resistant to both drugs, so have to take a different route
[11:11]  You: usually with interferon alpha
[11:11]  You: with pentostatin 60% achieve full remission
[11:12]  You: 25 % achieve partial remission with DCF (pentostatin)
[11:13]  You: with 2 CdA 90% achieve total remission
[11:13]  Natalie Balogh: omg 90%?!?!?!
[11:13]  You: Yah..so it is hightly curable
[11:13]  You: Usually the remainder receive some long-term responsivness
[11:14]  You: it’s rare that a person relapses or has resistance to 2 CdA

 Come join us for the fun

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