Standard treatment options in classic HCL (cHCL) result in high response rates and
near normal life expectancy. However, the disease itself and the recommended standard
treatment are associated with profound and prolonged immunosuppression, increasing
susceptibility to infections and the risk for a severe course of COVID-19. The Hairy
Cell Leukemia Foundation (HCLF) has recently convened experts and discussed different
clinical strategies for the management of these patients. The new recommendations
adapt the 2017 consensus for the diagnosis and management with cHCL to the current
COVID-19 pandemic. They underline the option of active surveillance in patients with
low but stable blood counts, consider the use of targeted and non-immunosuppressive
agents as first-line treatment for cHCL, and give recommendations on preventive measures
against COVID-19.
