English Summary: Spanish-Language HCL Webinar with Dr. Jacqueline Barrientos

In May 2025, the Hairy Cell Leukemia Foundation proudly hosted our first fully Spanish-language educational webinar, led by renowned hematologist Dr. Jacqueline Barrientos from the Mount Sinai Medical Center in Miami. This event marked a significant milestone in our ongoing commitment to reach and support Spanish-speaking patients and families affected by hairy cell leukemia (HCL).

Dr. Barrientos delivered a clear, empathetic, and insightful presentation on HCL, covering key topics such as diagnosis, current treatment options, and the latest advances in targeted therapies. Below are the highlights from this valuable session:

Understanding the Basics of HCL

  • Hairy cell leukemia is a rare disease, accounting for only 1.4% of lymphomas and 2% of all leukemias.

  • Approximately 1,000 to 1,500 cases are diagnosed annually in the U.S. Many oncologists may see only one case in their entire career.

  • It primarily affects men between the ages of 55 and 60, though it can also occur in younger or older individuals. The male-to-female ratio is 4:1.

Diagnosis: Accuracy is Crucial

  • Diagnosis requires a bone marrow biopsy, as aspiration often yields insufficient information.

  • Flow cytometry is used to identify B-cell markers such as CD19, CD20, CD11c, CD25, CD103, among others.

  • The most important marker is the BRAF V600E mutation, present in about 90% of classic HCL cases.

  • Dr. Barrientos emphasized the importance of distinguishing between classic HCL and the variant form, which is more aggressive and requires a different therapeutic approach.

When to Start Treatment vs. Watch and Wait

  • Not all newly diagnosed patients require immediate treatment. Around 10% can begin with “active surveillance.”

  • Treatment is recommended when:

    • Hemoglobin falls below 11 g/dL

    • Neutrophils drop below 1,000

    • Platelets fall below 100,000

    • There are frequent infections, intense fatigue, fever, night sweats, weight loss, or an enlarged spleen

Recommended First-Line Treatments

  • First-line therapies include cladribine and pentostatin, both purine analogs.

  • Cladribine is given for five consecutive days, and rituximab is added weekly for eight weeks.

  • Dr. Barrientos emphasized that even with dose adjustments, patients can achieve complete remission.

Advances and Clinical Trials

  • The combination of Vemurafenib (a BRAF inhibitor) with Rituximab has shown remarkable efficacy in relapsed patients.

  • Clinical trials have shown response rates close to 100%.

  • The combination doubled complete remission rates compared to Vemurafenib alone.

  • Combinations with Obinutuzumab (a more potent monoclonal antibody than Rituximab) have also been studied.

  • While drugs like Ibrutinib have been evaluated, their efficacy is limited and side effects can be significant.

  • The immunotoxin Moxetumomab showed promise but was withdrawn from the market.

Evaluating Treatment Response

  • Bone marrow should not be evaluated earlier than 4 to 6 months after treatment.

  • Complete remission is defined as:

    • Normal blood counts.

    • No evidence of hairy cells in bone marrow or peripheral blood using standard stains.

    • Spleen size has diminished.

  • Achieving minimal residual disease (MRD) negativity has been associated with longer-lasting remission.

A Success Story: Personalization and Hope
Dr. Barrientos shared an inspiring case: a 72-year-old patient with advanced kidney disease was diagnosed with HCL during evaluation for a transplant. Unable to receive standard chemotherapy, he was treated with adjusted doses of Vemurafenib and Rituximab. He achieved complete remission, received his kidney transplant, and is now living cancer-free and without dialysis—a clear example of personalized and collaborative medicine.

To access the Spanish-language webinar materials, CLICK HERE >>>
For more resources for Latino and Hispanic HCL patients, visit CLICK >>>

Carlos Guerrero