Bone marrow morphology is a strong discriminator between chronic eosinophilic leukemia, not otherwise specified and reactive idiopathic hypereosinophilic syndrome
Sa A. Wang,
Robert P. Hasserjian,
Wayne Tam,
Albert G. Tsai,
Julia T. Geyer,
Tracy I. George,
Kathryn Foucar,
Heesun J. Rogers,
Eric D. Hsi,
Bryan A. Rea,
Adam Bagg,
Carlos E. Bueso-Ramos,
Daniel A. Arber,
Srdan Verstovsek,
Attilio Orazi
Affiliations
Sa A. Wang
Department of Hematopathology, M.D. Anderson Cancer Center, Houston, TX, USA
Robert P. Hasserjian
Department of Pathology, Massachusetts General Hospital, Boston, MA, USA
Wayne Tam
Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, NY
Albert G. Tsai
Department of Pathology, Stanford University, CA, USA
Julia T. Geyer
Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, NY
Tracy I. George
Department of Pathology, University of New Mexico, Albuquerque, NM, USA
Kathryn Foucar
Department of Pathology, University of New Mexico, Albuquerque, NM, USA
Heesun J. Rogers
Department of Laboratory Medicine, Cleveland Clinic, OH, USA
Eric D. Hsi
Department of Laboratory Medicine, Cleveland Clinic, OH, USA
Bryan A. Rea
Department of Pathology and Laboratory Medicine, the University of Pennsylvania, Philadelphia, PA, USA
Adam Bagg
Department of Pathology and Laboratory Medicine, the University of Pennsylvania, Philadelphia, PA, USA
Carlos E. Bueso-Ramos
Department of Hematopathology, M.D. Anderson Cancer Center, Houston, TX, USA
Daniel A. Arber
Department of Pathology and Laboratory Medicine, University of Chicago, IL, USA
Srdan Verstovsek
Department of Leukemia, M.D. Anderson Cancer Center, Houston, TX, USA
Attilio Orazi
Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, NY
Chronic eosinophilic leukemia, not otherwise specified can be difficult to distinguish from idiopathic hypereosinophilic syndrome according to the current World Health Organization guideline. To examine whether the morphological features of bone marrow might aid in the differential diagnosis of these two entities, we studied a total of 139 patients with a diagnosis of chronic eosinophilic leukemia, not otherwise specified (n=17) or idiopathic hypereosinophilic syndrome (n=122). As a group, abnormal bone marrow morphological features, resembling myelodysplastic syndromes, myeloproliferative neoplasm or myelodysplastic/myeloproliferative neoplasm, were identified in 40/139 (27%) patients: 16 (94%) of those with chronic eosinophilic leukemia and 24 (20%) of those with hypereosinophilic syndrome. Abnormal bone marrow correlated with older age (P
