What Is Eosinophilic Leukemia?
Eosinophilic leukemia (EL) is a rare type of leukemia. It is characterized by abnormal eosinophilia in peripheral blood and bone marrow. It often affects the heart, lung, and nervous system, and presents with progressive anemia and thrombocytopenia. [1]
Eosinophilic leukemia
Basic overview of eosinophilic leukemia
- Eosinophilic leukemia (EL) is a rare type of leukemia. It is characterized by abnormal eosinophilia in peripheral blood and bone marrow. It often affects the heart, lung, and nervous system, and presents with progressive anemia and thrombocytopenia. [1]
Causes of eosinophil leukemia
- A small number of patients can evolve from idiopathic hypereosinophilic syndrome, and it can also be an advanced manifestation of very few acute lymphocytic leukemias or chronic myeloid leukemias.
- The pathogenesis has not been elucidated. It has been reported that patients with hematopoietic cells overexpress Wilms tumor gene and cause apoptosis to be suppressed. Patients may have clonal chromosomal abnormalities but no marker chromosomes. [2]
Eosinophilic leukemia disease test
- Blood image
- Common anemia and thrombocytopenia, the number of white blood cells increased significantly, up to (50 200) × 109 / L, eosinophils accounted for 20% 90%, most of which were above 60%. The increase of late juveniles mainly. Proto- and early-maize are rare.
- Bone marrow
- In addition to the increase in the proportion of protoblasts, eosinophils increased significantly and shifted to the left. According to the cell morphology, it can be divided into three types: Promyelocytic type: Hematopoietic and bone marrow have increased myeloblasts. Juvenile cell type: In addition to the obvious increase of bone marrow naive eosinophils, such cells can also be seen in peripheral blood. mature cell type: mainly mature eosinophils, including increased eosinophils and late immature granulocytes, primordial granulocytes are normal or slightly increased.
- Chromosome examination
- Chromosome 8 and 10 trisomy, 4q and 45X, 49XY and other chromosome abnormalities.
- Cell Culture
- Peripheral blood cell CFU-GM growth results are similar to chronic myelogenous leukemia, and its growth mode combined with chromosome examination can be used to distinguish eosinophilic leukemia from other causes of eosinophilia.
- According to clinical manifestations, symptoms, signs, choice of chest radiography, CT, B ultrasound, electrocardiogram and other examinations. [3]
Clinical diagnosis of eosinophilic leukemia
- The length and speed of eosinophilic leukemia are related to the maturity of eosinophils, so they are generally divided into two types clinically.
- Acute type
- This disease is different from general leukemia in that it has less infection and bleeding, mainly due to infiltration of eosinophils in various organs, leading to dysfunction. In addition to the involvement of the liver, spleen, and lymph nodes, it also manifests as heart, lung, and central nervous system involvement. Clinical manifestations of progressive heart failure often include galloping rhythms, pericardial fricatives; cough, dyspnea; if there is central nervous system infiltration, manifested as mental disorders, delusions, blurred vision, ataxia, hemiplegia, etc. In addition, erythema, pimples, nodules, etc. may appear on the skin.
- chronic
- Slow onset, the course can be extended to 2 to 8 years. There are weakness, anemia, liver and spleen, and enlarged lymph nodes.
- Diagnosis and evaluation: EL is rare, and the diagnosis must be very careful, and eosinophilia caused by other reasons must be fully excluded. Hematological examination, in addition to eosinophilia, it should have morphological abnormalities. The presence of naive eosinophils in the blood and blast cells in the bone marrow> 5% is also a prerequisite. In the case of suspicious cases with inadequate conditions, the primary disease should continue to be searched and the changes in the condition should be carefully observed. [4]
Treatment of eosinophil leukemia
- In principle, eosinophilic leukemia is treated according to AML, and the protocol can be used. Some cases are sensitive to vincristine and hydroxyurea. Those with central nervous system involvement should be injected intrathecally. Those with clinical manifestations of increased histamine can try H1 and / or H2 receptor blockers. [5]