Abstract
Significant peripheral eosinophilia in association with acute graft-versus-host disease (GVHD) is rare. Here we report a case of eosinophilia in a 30-year-old woman with relapsed acute myelogenous leukemia after an allogeneic bone marrow transplant who was treated with donor lymphocyte infusion (DLI). A month after the DLI, she developed a pruritic erythematous rash, hepatic enzyme elevations and eosinophilia that peaked at 23,300 cells/mm3. A diagnosis of acute GVHD was made and the patient was treated with corticosteroids with a resolution of all of the aforementioned findings. The authors suggest that eosinophilia in a bone marrow transplantation patient should raise suspicion of GVHD.
References
1.
Couriel D, Caldera H, Champlin R, Komanduri K: Acute graft-versus-host disease: pathophysiology, clinical manifestations, and management. Cancer 2004;101:1936–1946.
2.
Porter D, Levine JE: Graft-versus-host disease and graft-versus-leukemia after donor leukocyte infusion. Semin Hematol 2006;43:53–61.
3.
Jacobsohn DA, Schechter T, Seshadri R, et al: Eosinophilia correlates with the presence or development of chronic graft-versus-host disease in children. Transplantation 2004;77:1096–1100.
4.
Daneshpouy M, Socie G, Lemann M, et al: Activated eosinophils in upper gastrointestinal tract of patients with graft-versus-host disease. Blood 2002;99:3033–3040.
5.
Janin A, Ertault-Daneshpouy M, Socie G, et al: Eosinophils and severe forms of graft-versus-host disease. Blood 2003;101:2073.
6.
Basara N, Kiehl MG, Fauser AA: Eosinophilia indicates the evolution to acute graft-versus-host disease. Blood 2002;100:3055.
7.
McNeel D, Rubio MT, Damaj G, et al: Hypereosinophilia as a presenting sign of acute graft-versus-host disease after allogeneic bone marrow transplantation. Transplantation 2002;74:1797–1800.
8.
Bain BJ: Eosinophilia – idiopathic or not? N Engl J Med 1999;341:1141–1143.
9.
Tefferi A, Vardiman JW: Classification and diagnosis of myeloproliferative neoplasms: the 2008 World Health Organization criteria and point-of-care diagnostic algorithms. Leukemia 2008;22:14–22.
10.
Chusid MJ, Dale DC, West BC, Wolff SM: The hypereosinophilic syndrome: analysis of fourteen cases with review of the literature. Medicine (Baltimore) 1975;54:1–27.
© 2008 S. Karger AG, Basel
2008
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