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Hypereosinophilia during 2‐chlorodeoxyadenosine treatment for hairy cell leukaemia
Author(s) -
Rutella Sergio,
Sica Simona,
Rumi Carlo,
Martucci Robert,
Etuk Benedict,
De Stefano Valerio,
Testa Ugo,
Leone Giuseppe,
Peschle Cesare
Publication year - 1996
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1046/j.1365-2141.1996.00869.x
Subject(s) - eosinophilia , eosinophil , hypereosinophilia , medicine , immunology , eosinophil cationic protein , daclizumab , hypereosinophilic syndrome , population , monoclonal antibody , antibody , environmental health , asthma
A 43‐year‐old male with newly diagnosed hairy cell leukaemia underwent a single course of 2‐chlorodeoxyadenosine (2‐CdA). Skin rash, facial swelling and marked eosinophilia developed 20 d after treatment and were resolved by 7 d of steroid therapy. Eosinophil peak in peripheral blood reached 1230 cells/μl. Flow cytometric analysis of the eosinophil population showed a high expression of the IL‐2 receptor α‐chain (CD25), representing up to 94% of gated cells. HLA‐DR and CD4 antigens were constantly negative; eosinophils strongly reacted with the secretory form of the eosinophil cationic protein (ECP), recognized by EG2 monoclonal antibody. IL‐5 serum levels were markedly elevated at the onset of eosinophilia, returned to normal levels after its disappearance and positively correlated with eosinophil count ( r = 0.94, P = 0.016). Eosinophilia is an uncommon finding after treatment with 2‐CdA. It is unclear whether these phenomena represented a true allergic reaction to the drug or the effect of massive tumour cell lysis and haemopoietic pancytopenia with immunosuppression, which induced the release of IL‐5 and possibly other cytokines.