Chronic eosinophilic leukemia

Chronic eosinophilic leukemia
Other names: CEL
SpecialtyHematology, oncology

Chronic eosinophilic leukemia is a form of cancer in which too many eosinophils are found in the bone marrow, blood, and other tissues. Most cases are associated with fusion genes. [1]

Signs and symptoms

a) Hyperpigmented plaques with scaling on the elbows, b) dystrophic fingernails, c) dystrophic toenails

Signs and symptoms may include weight loss, fever, malaise, cough, skin and mucosal lesions, diarrhea, and peripheral neuropathy. Cardiac symptoms are also possible.[2]

In cases associated with PDGFRB and FGFR1 mutations, splenomegaly is common. Lymphadenopathy is also common with FGFR1 mutations.[2]

Infiltration of eosinophils causes organ damage.[3]

Causes

Most cases of CEL are associated with rearrangements in PDGFRA, PDGFRB, or FGFR1.[4]

CEL not otherwise specified (CEL NOS) is a form in which BCR-ABL1 fusion genes and PDGFRA, PDGFRB, and FGFR1 rearrangements are not found.[5]

Diagnosis

For a diagnosis of CEL, hypereosinophilia with greater than 30% eosinophils is required.[4] Serum IgE is usually normal. In cases associated with PDGFRB, serum vitamin B12 and tryptase may be elevated.[2]

Treatment

The management for Chronic eosinophilic leukemia is systemic steroids, and hydroxyurea[6]

Prognosis

CEL associated with a mutation in PDGFRA is treatable with imatinib and has an excellent prognosis. On the other hand, CEL associated with FGFR1 mutations has a very poor prognosis.[4] Progression can occur from CEL to AEL or AML in rare cases.[4]

Epidemiology

Cases occur in people of all ages. The disease is more common in males than females.[2]

References

  1. ↑ "Chronic Eosinophilic Leukemia". The Lecturio Medical Concept Library. Archived from the original on 9 July 2021. Retrieved 8 July 2021.
  2. 1 2 3 4 Jaffe, Elaine (2016-08-25). Hematopathology (2 ed.). pp. 931–941. ISBN 978-0-323-29613-7.
  3. ↑ McPherson (2011). Henry's Clinical Diagnosis and Management by Laboratory Methods (23 ed.). Elsevier. pp. 606–658. ISBN 9781437709742.
  4. 1 2 3 4 Hoffman, Ronald (2017-08-15). Hematology: basic principles and practice (Seven ed.). pp. 1151–1169. ISBN 978-0-323-35762-3.
  5. ↑ Aster, Jon. Hematopathology: A Volume in the High Yield Pathology Series. Elsevier. p. 222.
  6. ↑ Klion, Amy D. (29 October 2009). "How I treat hypereosinophilic syndromes". Blood. 114 (18): 3736–3741. doi:10.1182/blood-2009-07-143552. Archived from the original on 15 June 2022. Retrieved 24 June 2022.
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