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Using Abnormal Bone Marrow Features for DDx

Haematologica; 2017 Aug; Wang, Hasserjian, et al

Most patients with chronic eosinophilic leukemia, not otherwise specified and some with idiopathic hypereosinophilic syndrome, show abnormal bone marrow features similar to the ones seen in those with certain myelodysplastic conditions, according to a study involving 139 individuals. Participants had either chronic eosinophilic leukemia, not otherwise specified (n=17) or idiopathic hypereosinophilic syndrome (n=122). Investigators looked for abnormal bone marrow morphological features and evaluated their impact. Among the results:

  • Abnormal bone marrow features were seen in 94% of patients with chronic eosinophilic leukemia and 20% of those with hypereosinophilic syndrome.
  • Patients who were older, or had constitutional symptoms, anemia, abnormal platelet count, organomegaly, elevated lactate dehydrogenase concentration, abnormal karyotype, or presence of myeloid neoplasm-related mutations tended to have abnormal bone marrow.
  • Patients with abnormal bone marrow survived an average of ~4 years, vs not reached in those who did not have abnormal bone marrow.
  • This was also seen in hypereosinophilic syndrome patients.

Citation:

Wang S, Hasserjian R, Tam W, et al. Bone marrow morphology is a strong discriminator between chronic eosinophilic leukemia, not otherwise specified and reactive idiopathic hypereosinophilic syndrome. Haematologica. 2017;102(8):1352-1360. doi:10.3324/haematol.2017.165340.