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Eosinophilia in routine blood samples and the subsequent risk of hematological malignancies and death
Author(s) -
Andersen Christen Lykkegaard,
Siersma Volkert Dirk,
Hasselbalch Hans Carl,
Lindegaard Hanne,
Vestergaard Hanne,
Felding Peter,
Fine Olivarius Niels,
Bjerrum Ole Weis
Publication year - 2013
Publication title -
american journal of hematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.456
H-Index - 105
eISSN - 1096-8652
pISSN - 0361-8609
DOI - 10.1002/ajh.23515
Subject(s) - eosinophilia , medicine , gastroenterology , odds ratio , eosinophil , lymphoma , comorbidity , chronic lymphocytic leukemia , cancer , leukemia , immunology , asthma
Eosinophilia may represent an early paraclinical sign of hematological malignant disease, but no reports exist on its predictive value for hematological malignancies. From the Copenhagen Primary Care Differential Count ( CopDiff ) Database, we identified 356,196 individuals with at least one differential cell count (DIFF) encompassing the eosinophil count during 2000–2007. From these, one DIFF was randomly chosen and categorized according to no (<0.5 × 10 9 /L), mild (≥0.5–1.0 × 10 9 /L) or severe (≥1.0 × 10 9 /L) eosinophilia. From the Danish Cancer Registry and the Danish Civil Registration System, we ascertained hematological malignancies and death within 3 years following the DIFF. Using multivariable logistic regression odds ratios (ORs) were calculated and adjusted for previous eosinophilia in a DIFF, sex, age, year, month, C‐reactive protein, previous cancer, and comorbidity. ORs for developing Hodgkin's lymphoma (HL) was significantly increased in individuals exhibiting severe eosinophilia, OR = 9.09 (C.I. 2.77–29.84), P = 0.0003. The association with classical myeloproliferative neoplasms (cMPNs) showed an increasing risk with OR = 1.65 (1.04–2.61) P = 0.0322 and OR = 3.87 (1.67–8.96) P = 0.0016 for mild and severe eosinophilia. Eosinophilia was in a similar fashion associated with chronic lymphatic leukemia (CLL), OR = 2.57 (1.50–4.43), P = 0.0006 and OR = 5.00 (1.57–15.94), P = 0.0065, and all‐cause death, OR of 1.16 (1.09–1.24), P < 0.0001 and 1.60 (1.35–1.91), P < 0.0001. We confirm associations between eosinophilia and HL and cMPNs, and in addition for the first time demonstrate a dose‐dependent association between eosinophilia and CLL as well as death. Unexplained eosinophilia should prompt clinicians to consider conditions where early diagnosis may improve prognosis. Am. J. Hematol. 88:843–847, 2013. © 2013 Wiley Periodicals, Inc.