Hairy ell Leukemia – Cancer Example

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'Hairy Сell Leukemia' is an exceptional example of a paper on cancer. Hairy cell leukemia is a cancerous condition affecting principally the B lymphocytic cells of the body. It is not a very common condition and accounts for only 2 % of all leukemias. It derives its name from the appearance of the B cells which are seen in this condition and acquire an abnormal appearance. That is they are seen as hair-like leukemic cells. This disease has a male predisposition with a male to female incidence ratio of 4:1 and it principally affects males in the older age groups. This picture shows the appearance of irregular B cells.

The cell membranes have lost their normal shape as well. The main clinical feature observed in this disorder is the increased production of the abnormal B lymphocytes which do not possess the capability of performing their normal bodily functions. This increase hinders the production of other cells. No specific cause which leads to this malignant condition has been identified. The increased number of B cells disrupts the functioning of the bone marrow and result in decreased production of other blood cells which presents as pancytopenia.

The patients might also suffer from anemia. The abnormal cells also invade the spleen and this leads to an increased size of the spleen. The liver is also enlarged but this presentation is not very common. The lymph nodes might also be enlarged. This abnormal functioning of the B cells makes the patient vulnerable to attack by infective agents and in particular mycobacterial agents. Signs and symptoms of the disease include the presence of swellings in the neck, axilla or other regions of the body.

These swellings are not painful. The patient might complain of dyspnea and loss of weight without any particular reason. Other symptoms include the feeling of being lethargic and recurrent infections with pyrexia. The patient might also experience pain in the abdomen or complain about abdominal discomfort.   Hairy cell leukemia can be diagnosed by means of physical examination as well as laboratory tests. The physical examination should focus upon checking the signs which include enlarged spleen and lymph nodes as well as swellings in other regions of the body.

A detailed history is also important to check for the other signs of the condition. Laboratory tests include the Complete blood count (CBC) which assists in finding out the number of all blood cells as well as the level of hemoglobin. A peripheral blood smear is also obtained to observe the appearance and shape of the cells. Bone marrow aspiration is obtained to check for signs of malignancy. A computed tomography scan of the abdomen is performed to check for enlarged spleen and lymph nodes. The first line of treatment for hairy cell leukemia is the provision of chemotherapeutic agents which include Cladribine and Leustatin.   If the patient does not respond to this treatment, monoclonal antibodies or interferon-alpha are administered to improve the condition of the patient.

Other forms of treatment include the surgical procedure of removing the spleen if it has been highly invaded by the cells. Bone marrow transplantation is the last resort.

References

Besa E.C., Woermann U. Hairy Cell Leukemia. 2008. Retrieved from http://emedicine.medscape.com/article/200580-overview

Dugdale D. Hairy cell leukemia - microscopic view. 2008.Retrieved from http://www.nlm.nih.gov/medlineplus/ency/imagepages/1453.htm

Kumar, Vinay, Abul K. Abbas, Nelson Fausto, Stanley L. Robbins, and Ramzi S. Cotran. Robbins and Cotran Pathologic Basis of Disease. Philadelphia: Elsevier Saunders, 2005.

Mohan, Harsh. Textbook of Pathology. New Delhi: Jaypee Bros, 2005.

National Cancer Institue. General Information about Hairy Cell Leukemia. 2010. U.S. National Institutes of Health. Retrieved from http://www.cancer.gov/cancertopics/pdq/treatment/hairy-cell-leukemia/Patient

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