Management of hairy cell leukaemia in pregnancy

Background Hairy cell leukaemia (HCL) represents less 1% of all lymphoid neoplasms with cases rarely reported in pregnancy. Management of HCL requires multidisciplinary care to optimise maternal and neonatal outcomes. Methods A literature search of Ovid MEDLINE and EMBASE for ‘hairy cell leukaemia’ and ‘Pregnancy’ was undertaken. Results Thirteen cases were reviewed including three within our own institutions. Interferon-alpha was the most prominent treatment at varying doses in n = 3 (23%) patients. Other management included antenatal cladribine and rituximab, post-partum cladribine with and without rituximab, laparoscopic splenectomy and termination of pregnancy. 46.1% (n = 6) of patients birthed vaginally. Due to thrombocytopenia, there was a greater proportion of caesarean delivery under general anaesthetic and half of the cases documented bleeding complications. Conclusion Diagnosis and management of HCL in pregnancy is difficult. Women can be managed safely and outcome aims should be the same as non-pregnant patients.