Introduction: There are only a few available data about hairy cell leukemia (HCL) in very old patients. We presented three very different cases of HCL in very old patients diagnosed in a single center and discussed some epidemiological and therapeutical issues in such patients.
Case report: The first patient, 89-year-old, had symptomatic cytopenia and achieved sustained complete remission after cladribine treatment. The second patient, 89-year-old, had asymptomatic disease with stable full blood counts during a 3-year follow-up period in which watch-and-wait policy was adopted. The third patient, 82 years old, had two malignancies (HCL and presumably metas- tatic colorectal carcinoma) and his only treatment were occasional red blood cell transfusions and symptomatic therapy.
Conclusion: The presented illustrative examples confirm individualization of treatment is mandatory in very old patients with HCL.