Treatment of Hairy-Cell Leukemia in a Pregnant Patient

Hairy-cell leukaemia (HCL) presenting during pregnancy is an exceptionally rare clinical situation. Only a small number of cases have ever been reported, and this scarcity means that clinical decision-making must draw carefully from limited evidence.

Clinical Scenario

A pregnant patient presents with hairy-cell leukaemia requiring evaluation for treatment. Managing this scenario demands a careful balance between controlling the disease and preserving fetal safety — factors that significantly shape which therapeutic interventions are appropriate at each stage of gestation.

Treatment Approach

When treatment is indicated in this setting, the choice of intervention is guided by the relative risks to both mother and fetus. A surgical approach may be among the options considered, with gestational timing playing an important role in that decision.

Full sequencing, patient-specific criteria, and the complete algorithm are in the structured protocol below.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1093/annonc/mdv200

Only a few cases of HCL during pregnancy have been reported [52, 53].

If treatment is indicated, the lower risks associated with IFN-α for both the mother and the fetus make it the treatment of choice [V, B].

Splenectomy is another option to consider, should INF-α fail, especially in early gestation when the risks are lower [V, B] [52, 55].

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