THE SPECTRUM OF HYPEREOSINOPHILIA AND ASSOCIATED CLONAL DISORDERS – A REAL WORLD DATA FROM A TROPICAL SETTING.

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Sreejesh Sreedharanunni
Neelam Varma *
Man Updesh Singh Sachdeva
Shano Naseem
Pankaj Malhotra
Deepak Bansal
Amita Trehan
Subhash Varma
(*) Corresponding Author:
Neelam Varma | varmaneelam@yahoo.com

Abstract

Objective: To determine the frequency, etiological spectrum and treatment outcome of hypereosinophilia (HE) and hypereosinophilic syndrome (HES) in a tropical setting.

Methods:  A retrospective analysis of hospital data of five years and a comprehensive prospective evaluation of patients presenting with HE/HES over a period of 33 months was performed.

Results: HE/HES was diagnosed in total of 125 patients during study period with an estimated prevalence of 0.5-1 case per one lakh population in our hospital settings. Infections, especially helminthes were the commonest cause (34%) followed by primary/clonal HE/HES (24%) and reactive HE/HES secondary to various clonal disorders (14.3%). Lymphocytic variant of HES and FIP1L1-PDGFRA positive HES were diagnosed in 3.6% each.  Imatinib responsive BCR-ABL1 negative HE/HES constitute 7.1% in our patients.

Conclusions: None of the clinical or routine laboratory features including the age of patients, duration of HE, presence or absence of organomegaly, hemoglobin levels, eosinophil %, absolute eosinophil count, total leukocyte count, platelet counts, serum IgE levels or presence of myelofibrosis can be used to predict or exclude malignancy in patients with HE/HES. The absence of blasts in peripheral blood or the absence of >5% blasts in bone marrow does not exclude primary/clonal HES. Clonal disorders (Primary HES and reactive HES secondary to clonal disorders; 38%) are diagnosed with nearly equal frequency compared to infections (34%) in tropical settings necessitating a thorough follow-up and comprehensive work-up in these patients.


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Article Details

Author Biographies

Sreejesh Sreedharanunni, Postgraduate Institute of Medical Education and Research, Chandigarh, India -160012

Assistant Professor, Department of Hematology

Neelam Varma, Department of Hematology Postgraduate Institute of Medical Education and Research Chandigarh

Professor and Head, Department of Hematology

Man Updesh Singh Sachdeva, Postgraduate Institute of Medical Education and Research, Chandigarh, India -160012.

Additional Professor, Department of Hematology

Shano Naseem, Postgraduate Institute of Medical Education and Research, Chandigarh, India -160012.

Additional Professor,  Department of Hematology

Pankaj Malhotra, Postgraduate Institute of Medical Education and Research, Chandigarh, India -160012.

Professor,  Department of Internal Medicine (Clinical hematology)

Deepak Bansal, Postgraduate Institute of Medical Education and Research, Chandigarh, India -160012.

Department of Pediatrics (Hematology/oncology unit)

Amita Trehan, Postgraduate Institute of Medical Education and Research, Chandigarh, India -160012.

Professor and Head,  Department of Pediatrics (Hematology/oncology unit),

Subhash Varma, Postgraduate Institute of Medical Education and Research, Chandigarh, India -160012.

Professor and Head,  Department of Internal Medicine

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