Chronic eosinophilic leukemia, NOS
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Autonomous clonal proliferation of eosinophilic precursors results in persistently increased numbers of eosinophils in the blood, bone marrow, and peripheral tissues.
The peripheral blood and bone marrow are always involved. Tissue infiltration by the eosinophils and release of cytokines and tumoral factors from the eosinophil granules lead to tissue damage in a number of organs, but the heart, lungs, CNS, skin and GI tract are commonly involved.
The patient must have a sustained absolute eosinophil count greater than 500/pl that persists longer than six months. The physician excludes reactive eosinophilia, eosinophilia secondary to other neoplastic diseases including T-cell neoplasia and other myeloid disorders. If above excludes peripheral blood blasts >2%, bone marrow >5% but <19%.
HES is traditionally treated with prednisone. Second-line drugs are interferon or hydroxyurea which induce remission in the majority of patients. If the prednisone. interferon and hydroxyurea are not effective, the patient may receive various chemotherapeutic drugs.