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Aim: Sarcopenia may develop in patients with hairy cell leukemia (HCL). There is no study in the literature showing the prognostic importance of sarcopenia in patients with HCL. In this study, the effect of pretreatment sarcopenia on clinical outcomes in patients with HCL was investigated. Methods: This study included 34 patients with pre-treatment abdominal computed tomography (CT) images who received cladribine (purine nucleoside analog) treatment between April 2006 and April 2022 at Ondokuz Mayıs University Hospital. To ensure measurement standardization, measurements were performed using abdominal CT sections showing the L3 vertebra. The optimal cut-off value for the skeletal mass index to be used for the prediction of sarcopenia was determined by receiver operating characteristic analysis. Patients were divided into two groups according to whether they were sarcopenic or not, and their clinical results were compared. Results: Overall survival (OS) tended to be shorter in the sarcopenic group than in the non-sarcopenic group (p=0.046). Progression-free survival was significantly better in the non-sarcopenic group than in the sarcopenic group (p=0.009). In the multivariate analysis, sarcopenia (hazard ratio=0.154, p=0.043) was an effective variable for OS. Conclusion: Sarcopenia is a prognostic factor for prognosis and treatment parameters in patients with HCL.

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