TITLE

Hypereosinophilic Syndrome and Clonal Eosinophilia: Point-of-Care Diagnostic Algorithm and Treatment Update

AUTHOR(S)
Tefferi, Ayalew; Gotlib, Jason; Pardanani, Animesh
PUB. DATE
February 2010
SOURCE
Mayo Clinic Proceedings;Feb2010, Vol. 85 Issue 2, p158
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Acquired eosinophllia is operationally categorized into secondary, clonal, and Idiopathic types. Causes of secondary eosinophilia include parasite infections, allergic or vasculitis conditions, drugs, and lymphoma. Clonal eosinophilia is distinguished from Idiopathic eoslnophilia by the presence of histologic, cytogenetic, or molecular evidence of an underlying myeloid malignancy. The World Health Organization classification system for hematologic malignancies recognizes 2 distinct subcategories of clonal eosinophilla: chronic eoslnophilic leukemia, not otherwise specified and myeloid/lymphoid neoplasms with eosinophilia and mutations involving platelet-derived growth factor receptor α/β or fibroblast growth factor receptor 1. Clonal eosinophilia might also accompany other World Health Organization-defined myeloid malignancies, Including chronic myelogenous leukemia, myelodysplastic syndromes, chronic myelomonocytic leukemia, and systemic mastocytosis. Hypereosinophilic syndrome, a subcategory of Idiopathic eosinophilla, is defined by the presence of a peripheral blood eoslnophil count of 1.5 × 109/L or greater for at least 6 months (a shorter duration is acceptable in the presence of symptoms that require eosinophil-lowering therapy), exclusion of both secondary and clonal eosinophilia, evidence of organ involvement, and absence of phenotypically abnormal and/or clonal T lymphocytes. The presence of the latter defines lymphocytic variant hypereosinophilia, which is best classified under secondary eosinophilia. In the current review, we provide a simplified algorithm for distinguishing the various causes of clonal and idiopathic eosinophilla and discuss current therapy, including new drugs (imatinib mesylate, alemtuzumab, and mepolizumab).
ACCESSION #
48143758

 

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