More than 95% of new patients are treated well or at least adequately by cladribine or pentostatin.A majority of new patients can expect a disease-free remission time span of about ten years, or sometimes much longer after taking one of these drugs just once. If re-treatment is necessary in the future, the drugs are normally effective again, although the average length of remission is somewhat shorter in subsequent treatments.
How soon after treatment a patient feels "normal" again depends on several factors, including:
- how advanced the disease was at the time of treatment;
- the patient's underlying health status;
- whether the patient had a "complete response" or only a partial response to the treatment;
- whether the patient experienced any of the rare, but serious side effects such as kidney failure;
- how aggressive the individual's disease is;
- whether the patient is experiencing unusual psychological trauma from the "cancer" diagnosis; and
- how the patient perceived his or her pre-treatment energy level and daily functioning.
With appropriate treatment, the overall projected lifespan for patients is normal or near-normal. In all patients, the first two years after diagnosis have the highest risk for fatal outcome; generally, surviving five years predicts good control of the disease. After five years' clinical remission, patients with normal blood counts can often qualify for private life insurance with some companies.[http://www.euclidmanagers.com/downloads/legrev/rblegrev/RTBaugust.pdf
Despite decade-long remissions and years of living very normal lives after treatment, hairy cell leukemia is officially considered an incurable disease. Relapses have happened even after more than twenty years of continuous remission. Patients will require lifelong monitoring and should be aware that the disease can recur even after decades of good health.
HCL patients are also at a slightly higher than average risk for developing a second kind of cancer at some point during their lives (including before their HCL diagnosis). There is also a higher risk of developing an autoimmune disease. On average, patients might reasonably expect to have as much as double the risk of developing another cancer, with a peak about two years after HCL diagnosis and falling steadily after that, assuming that the HCL was successfully treated. Aggressive surveillance and prevention efforts are generally warranted, although the lifetime odds of developing a second cancer after HCL diagnosis are still less than 50%.
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