About 10% of
Hairy Cell Leukemia patients remain asymptomatic with normal blood cell counts
and never require treatment.
Hairy Cell Leukemia becomes warranted given the onset of:
cytopenias: neutropenia, anemia or thrombocytopenia
constitutive symptoms: fever, fatigue, night sweats.
naïve: cladrabine and pentostatin are the treatments of choice.
successfully and relapsed: If the patient responded initially and subsequently
relapsed, a second course of the same medication as that initially used will be
successful in about 70% of cases.
failure: treatment is indicated with a different purine analog from the one that
failed. Thus, if cladrabine was the first choice, treatment should be switched
to pentostatin – or vice versa.
considered indicated for the treatment of Hairy Cell Leukemia:
initial treatment of symptomatic Hairy Cell Leukemia (C91.40); OR
of relapse (C91.42) after successful initial treatment with Leustatin; OR
of patients who had no benefit from an initial course of pentostatin or
considered experimental and investigational for all other uses.
This drug can be ordered through a contracted specialty pharmacy company. This
option will provide the medication to the physician’s office on the day
specified and in the dose required, at no expense to the physician. Billing for
the medication, in this circumstance, will be handled by the specialty pharmacy;
the physician will bill appropriate administration charges.
Codes Used In This BI:
J9065 Inj cladribine per 1 MG