Professor Ella Naparstekleading hematologist and hemato-oncologist
Israeli medicine is rightly considered a world leader in oncohematology due to colossal investments in science and clinical research. At the Ichilov clinic, achieving deep and durable remission becomes a reality even in complex cases thanks to access to the latest targeted drugs and biological agents. Doctors apply personalized protocols, and the use of molecular-genetic methods allows for therapy that effectively translates the disease into a state of long-term and stable control.
Stays at the clinic are organized with a focus on exceptional attention to the needs of the patient and their loved ones. Bright, modern rooms and the delicate care of medical staff create an atmosphere of calm and confidence in success. A personal companion takes care of all organizational and everyday issues, ensuring seamless communication with doctors and coordination of procedures. This support alleviates unnecessary worries, allowing patients to fully concentrate on regaining strength and resting comfortably.
About the Disease
Hairy cell leukemia is a rare form of chronic lymphocytic leukemia, characterized by the accumulation of abnormal B-lymphocytes with distinctive "hairy" projections on their surface in the bone marrow and spleen. The disease progresses slowly and often remains asymptomatic for a long time. A leading role in the development of the disease is played by a mutation in the BRAF gene, causing uncontrolled cell division. Risk factors include age over 50, male gender, exposure to chemicals, and radiation.
Hairy cell leukemia causes significant discomfort due to the reduction of normal blood cells (pancytopenia) and spleen enlargement.
- Persistent fatigue, weakness, and shortness of breath associated with anemia.
- Easy bruising and bleeding due to thrombocytopenia.
- Pain in the left upper abdomen and early satiety during meals due to spleen enlargement.
- Frequent infections with fever caused by reduced immunity.
- Gradual worsening of symptoms without treatment, significantly reducing quality of life.
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Treatment Methods
At Ichilov, the choice of treatment methods for hairy cell leukemia is determined by the stage of the disease, the degree of bone marrow involvement, blood parameters, and the overall condition of the patient, allowing for the development of an optimal therapeutic strategy.
Active Surveillance
After achieving remission or in cases of stable disease without the need for immediate treatment, patients are placed under regular medical supervision with monitoring of blood parameters and bone marrow condition. The active monitoring strategy allows for timely detection of signs of progression and initiation of therapy at the optimal moment. The frequency of visits and the extent of examinations are determined individually based on the characteristics of the disease course and response to previous treatment. This approach eliminates unnecessary toxicity during remission periods and ensures a quick response when therapy needs to be resumed.
Chemotherapy with Purine Nucleoside Analogs
When the disease manifests with significant reductions in blood parameters or spleen enlargement, specific chemotherapeutic agents that selectively target pathological cells are used. Purine nucleoside analogs are incorporated into the DNA of leukemic cells and block their division, leading to the gradual death of the tumor population. Drugs in this group are administered intravenously in a short course, usually over several days, followed by a long break for recovery. The high efficacy of the method allows for complete remission in most patients after the first course of therapy.
Monoclonal Antibody Immunotherapy
In early stages or upon disease recurrence, when chemotherapy is undesirable due to comorbidities, specialists turn to targeted immunotherapy. Monoclonal antibodies recognize specific proteins on the surface of leukemic cells and mark them for destruction by the body's immune system. Ichilov uses modern drugs that are administered on an outpatient basis under the supervision of medical staff. This method is characterized by good tolerability and can be used in elderly patients or in those with contraindications to standard chemotherapy.
Combined Chemoimmunotherapy
In cases of aggressive disease progression or incomplete response to monotherapy, doctors use a combination of chemotherapeutic agents with immunological agents to enhance the anti-tumor effect. The combined approach allows for simultaneous targeting of leukemic cells through multiple mechanisms, increasing the likelihood of achieving deep remission. The treatment regimen is carefully planned considering possible drug interactions and individual tolerability. Regular monitoring of blood parameters and bone marrow condition helps to timely adjust dosages and assess the effectiveness of therapy.
Splenectomy
When the spleen reaches significant sizes and causes discomfort, or its removal may improve blood parameters, surgical intervention is considered. An enlarged spleen destroys healthy blood cells and exacerbates disease manifestations, making its removal a necessary step in treatment. At Ichilov, the surgery is often performed laparoscopically through small incisions, reducing recovery time and lowering the risk of complications. After splenectomy, many patients report improved well-being and normalization of blood parameters, creating favorable conditions for further therapy.
Interferon Therapy
In cases of slow disease progression or when more aggressive methods cannot be used, interferon drugs are employed to modulate the immune response and slow the growth of tumor cells. Interferons are administered subcutaneously several times a week over a long period, requiring discipline and regular monitoring. Although the effect develops gradually, the method allows for disease control in patients with contraindications to standard chemotherapy. Modern pegylated forms of interferon have improved tolerability and require less frequent administration.
Transfusion Support
When the levels of blood components critically decrease due to bone marrow involvement, patients receive transfusions of necessary components to maintain vital functions. Red blood cell transfusions alleviate anemia and restore the blood's ability to carry oxygen, while platelet transfusions prevent dangerous bleeding. Each procedure is performed considering blood group compatibility and individual patient characteristics. Replacement therapy serves as a temporary bridge to the main treatment, allowing for the safe administration of necessary chemotherapy courses.
Antibiotic Prophylaxis and Antiinfective Therapy
Against the backdrop of reduced immunity characteristic of hairy cell leukemia, the body becomes vulnerable to bacterial, viral, and fungal infections. Prophylactic administration of antimicrobial agents helps prevent the development of severe infectious complications during treatment. Specialists tailor the prophylaxis regimen individually, based on the degree of immunosuppression and specific risk factors for the patient. Upon signs of infection, targeted therapy is promptly initiated using modern broad-spectrum antimicrobial agents.
- Splenectomy (removal of the spleen): treatment in Israel
- Chemotherapy
Diagnostic Methods for the Disease
Accurate diagnosis of hairy cell leukemia is a critical factor, as this rare form of the disease requires specific therapy distinct from the treatment of other types of blood cancer. At Ichilov, examinations are conducted on high-precision expert-class equipment, eliminating the risk of error. All diagnostic procedures are planned in advance, even before the patient's arrival, and are carried out in the shortest possible time, allowing for immediate initiation of effective treatment.
First Day
Upon arrival at the clinic, the patient is immediately directed to a primary consultation with a leading hemato-oncologist. The doctor conducts a thorough physical examination and collects a detailed medical history, documenting all symptoms and disease characteristics. Based on the obtained data, the specialist formulates a program of investigations necessary to obtain a complete clinical picture of the patient's condition and assess the functions of vital organs.
Second Day
To confirm the diagnosis and assess the extent of the process, the patient is assigned a comprehensive set of specialized tests:
- Complete blood count
- Biochemical blood analysis
- Cytogenetic study
- Flow cytometry (immunophenotyping)
- Bone marrow biopsy
- Trepanobiopsy
- Ultrasound examination of the abdominal organs
- Computed tomography (CT)
Third Day
At the final stage, the attending physician gathers a multidisciplinary council involving related specialists to analyze the obtained results. Joint discussion of the case allows for consideration of all individual patient characteristics, the molecular profile of the tumor, and comorbidities. This approach ensures the formulation of the most relevant and effective treatment plan aimed at achieving deep remission.
Diagnostic Procedures
- Biopsy
- Computed Tomography
- Ultrasound
- Blood Biochemistry
How Much Does Treatment Cost in Israel
The cost of therapy in Israeli oncology centers is formed individually, based on the stage of the disease and the chosen protocol: targeted, immunotherapy, or chemotherapy. Major expense items include high-precision genetic diagnostics (including BRAF V600E mutation), hospital stay, use of original next-generation medications, and subsequent monitoring of minimal residual disease. Investments in treatment in Israel are justified by the highest percentage of achieving long-lasting, multi-year remission.
For an accurate personalized price calculation, you need to contact the clinic consultant at the phone number listed on the website.
Advantages of Treatment in Israel
- World-class hemato-oncologists with extensive experience in treating rare forms of blood cancer
- Access to innovative targeted drugs and next-generation biological agents
- High-tech laboratory diagnostics for ultra-precise determination of the tumor's molecular profile
- Individual therapy protocols with minimal risk of side effects and complications
- Comfortable conditions during the stay at the clinic and comprehensive support from medical staff
Even before flying to Israel, you can take advantage of the "Second Opinion" service by ordering a video consultation with a leading specialized hematologist. Following the online meeting, you will receive detailed recommendations on treatment tactics, answers to all your concerns, and comprehensive information about the most modern technologies available for your clinical case.