New Targeted Therapy Combination Holds Promise to Untangle Hairy Cell Leukemia.

Soong, Deborah; Taylor, Justin · NEJM Evid · 2023

review · Level V

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Abstract

Hairy cell leukemia (HCL) is an uncommon B-cell neoplasm uniquely characterized by a high prevalence of the <i>BRAF<sup>V600E</sup></i> mutation, which leads to constitutive activation of the mitogen-activated protein kinase (MAPK) pathway.<sup>1</sup> In fact, the <i>BRAF<sup>V600E</sup></i> point mutation is identified in nearly all cases of HCL; however, it is absent in HCL variant (vHCL) and rare in other B-cell neoplasms.<sup>2,3</sup> Notably, in contrast to melanoma or other BRAF mutant solid tumors, HCL exhibits very few other mutations, potentially explaining the high response rates observed in patients treated with mutant BRAF-targeted agents, such as vemurafenib.

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