Supportive treatments for hairy cell leukaemia

Hairy cell leukaemia (HCL) and its treatment can cause problems. Supportive treatments can help to either prevent or control these problems.  

The problems or symptoms you have depend on how the HCL is affecting your body. It can also depend on what treatment you have.

You might have some of the following supportive treatments:

• medicines to treat or prevent infections
• blood products

Treating infections

HCL and its treatment affect your immune system. So you are more at risk of getting infections.

It’s important to tell your hospital treatment team urgently if you have any signs of infection.

Symptoms include:

• a change in temperature
• aching muscles
• headaches
• feeling cold, shivery and generally unwell

You might have other symptoms depending on where the infection is.

For some infections you can have treatment at home. But other infections can be life threatening, and you will need treatment in hospital.

Treatment for infection includes:

• antibiotics which treat bacterial infections
• antiviral drugs which treat viral infections
• antifungal drugs which treat infection caused by a fungal infection

Preventing infections

Medicines to prevent infection

Doctors sometimes suggest you take medicines before you get an infection. This is to try to prevent it from happening. These are called prophylactic medicines. Prophylactic (pronounced prof-il-ak-tik) means preventative.

You might have medicines to prevent bacterial or viral infections.

Vaccines

Vaccines are a way of protecting you against certain infections. Your doctor is likely to suggest that you have:

• a yearly flu vaccine
• a vaccine to prevent pneumonia
• a coronavirus vaccine

There are two main types of vaccines. These are live vaccines and inactivated (not live) vaccines.

You shouldn't have live vaccines if you have HCL. This is because live vaccines contain a very weak version of the illness. Your doctor can tell you which vaccines are safe, and which ones to avoid.

Blood products

You might need to have a blood transfusion or platelet transfusion. This is because your bone marrow might not make enough red blood cells or platelets. This is a common problem caused by HCL and its treatment.

You should only have irradiated blood products following treatment with the chemotherapy drugs cladribine, pentostatin or bendamustine. The radiation kills any white cells in the blood products. This protects you from a rare reaction to the blood cells. You should carry a card or wear a bracelet to make doctors and nurses aware of this. This is important in case of an emergency.

Blood transfusion

A low red blood cell count is called anaemia. You can feel very tired and have little or no energy. You might also feel breathless when you move around. Your doctor will check your blood counts. 

You can have a blood transfusion if you are anaemic. This can help you to feel better.

Some people have a reaction to the blood, although this is rare. Tell your doctor or nurse if you feel hot or cold and shivery during the infusion. Your nurse will give you medicines to reduce the reaction.

Platelet transfusion

You might have low platelet levels. Platelets help the blood to clot. A low platelet level means you are at risk of bleeding. Tell your nurse or doctor straight away if you have any signs of unusual bleeding, such as:

• blood in your urine or when you have your bowels open
• bruises or tiny red spots on your skin
• nosebleeds

You might need a platelet transfusion. 

Some people have a reaction to the platelets. This can make you feel hot or very cold and shivery when you are having the transfusion. Tell your doctor or nurse if you have this. They will give you medicines to reduce the reaction.