Treatment

You have now made the diagnosis of Hairy Cell Leukemia and are planning to start treatment. Which is your first choice of treatment?

I THINK WE NEED TO CLARIFY WHY/HOW THE PATIENT MEETS CRITERIA FOR Tx INSTEAD OF WAIT AND WATCH

a
Cytarabine + Daunorubicin
b
Vincristine
c
Cladribine +/- Rituxan
Cladribine is the first line treatment for Hairy Cell Leukemia. Cladribine is a purine analog that is given as a single cycle of either 5 or 7 days and induces complete remission in >90% of cases.  Cladribine works by inhibiting adenosine deaminase, leading to accumulation of adenosine. Cladribine is activated by lymphocytes, and the accumulation of adenosine is toxic to lymphocytes. Rituximab can also be considered as an add on to cladribine.
d
Cyclophosphamide
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