Splenectomy, interferon, and treatments of historical interest in hairy cell leukemia

Hairy cell leukemia (HCL) is an uncommon leukemia. After Hodgkin lymphoma, HCL has been a model for incorporating and understanding the clinical interventions of surgery, chemotherapy, biologic response modifiers, purine nucleoside analogs, and monoclonal antibody therapy. Advances in treatment, all of which were empiric at the time, preceded advancements in understanding the biology of the disease. The history of therapeutic intervention has been characterized by empiric interventions without scientific bench research applied to a disease that did not have good outcomes or therapeutic interventions. Such approaches have changed the natural history of this disease and opened doors for other diseases. Over time, the definitions of response evolved into modern response definitions. This article focuses on treatments of historical interest, observation, splenectomy, and the interferons.