Gender and Prognosis Profiles in Hairy Cell Leukemia: Insights from a Population-Based Study (1996-2021)

Abstract

Epidemiological studies on hairy cell leukemia (HCL) are limited and absent for other “hairy cell proliferations” including the variant form of HCL (HCL-V) and splenic diffuse red pulp lymphoma (SDRPL). These last two entities are very similar and difficult to distinguish without resorting to splenectomy. We conducted a population-based study over the period 1996-2021 including 160 patients; 139 patients (87%) with HCL and 21 patients (13%) with HCL-V/SDRPL. The aim of this study was to determine by subgroups of patients the incidence, progression free survival (PFS), overall survival (OS) and time to next treatment (TTNT) in men and women.In the HCL subgroup, 82% of patients received first-line treatment. The median PFS was almost 13 years: 154 months in men and not reached (NR) in women without statistically significant difference between men and women. The median OS was 6 years without significant difference between men and women. Forty patients (35%) 32 men and 8 women relapsed and 32 of them received second-line therapy. The median PFS for relapsed HCL patients was 13 years: 156 months in men versus 12 months women (p<0,05). The TTNT1 was also longer in men 57.4 months and 17.9 months in women with a statistically significant difference between men and women (p=0.019).These results confirmed the relatively good prognosis of patients with HCL in both men and women. However, relapses in women could be more aggressive and need rapid intervention. Studies with a higher number of patients are needed to confirm these results.

Note:
Funding declaration: No funding

Conflict of Interests: All the authors declare that they have no COI and COD.

Ethical Approval:  In compliance with register regulations in France

Keywords: Hairy cell leukemia, HCL, variant form of hairy cell leukemia, HCL-V, incidence, prognosis, gender, overall survival, progression free survival, time to next treatment.