Atypical meningeal localization of classical hairy cell leukemia with an impressive response to rituximab and cladribine association. A case report and literature review

Bibliographic Details
Title: Atypical meningeal localization of classical hairy cell leukemia with an impressive response to rituximab and cladribine association. A case report and literature review
Authors: Fabien Claves, Sylvain Carras, Barbara Burroni, Elsa Maitre, Jean Boutonnat, Xavier Troussard, Lysiane Molina
Source: eJHaem, Vol 5, Iss 1, Pp 242-246 (2024)
Publisher Information: Wiley, 2024.
Publication Year: 2024
Collection: LCC:Diseases of the blood and blood-forming organs
Subject Terms: atypical localization, central nervous system, cladribine and rituximab, Hairy cell leukemia, Diseases of the blood and blood-forming organs, RC633-647.5
More Details: Abstract Hairy cell leukemia (HCL) is a rare lymphoproliferative disorder classically presenting with cytopenia and recurrent infections but atypical manifestations such as bone lesions, skin lesions and effusion have been described. We report here an unusual meningeal localization in a 33 years old man who presented with headache, hand paresthesia and visual symptoms. Brain magnetic resonance imaging revealed an occipital meningeal lesion. Diagnostic explorations led to the diagnosis of classical HCL with meningeal localization. After treatment by cladribine and rituximab the patient rapidly improved and is still in complete remission 12 months after end of treatment. The literature review identified 9 other cases of HCL with central nervous system localization (CNS) presenting with brain parenchyma and/or meninges localization. Four out of 9 patients presented with hyperleukocytosis. Most patients experienced good responses with various treatments. Cladribine alone or with rituximab led to complete responses similar to our patient. In our patient, molecular biology revealed KLF2 mutations, which implication in the atypical localization could be suspected but would need dedicated studies. In conclusion, CNS localizations of HCL are rare but can be observed and treatment with cladribine alone or with rituximab appears as an effective strategy.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 2688-6146
Relation: https://doaj.org/toc/2688-6146
DOI: 10.1002/jha2.841
Access URL: https://doaj.org/article/548ebd1e0d9840d4ba5f7a287c626a2b
Accession Number: edsdoj.548ebd1e0d9840d4ba5f7a287c626a2b
Database: Directory of Open Access Journals
More Details
ISSN:26886146
DOI:10.1002/jha2.841
Published in:eJHaem
Language:English