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International Journal of Hematology

, Volume 83, Issue 2, pp 152–155 | Cite as

Chronic Eosinophilic Leukemia with the FIP1L1-PDGFR± Fusion Gene in a Patient with a History of Combination Chemotherapy

  • Yasuhiro Tanaka
  • Masayuki Kurata
  • Katsuhiro Togami
  • Haruyuki Fujita
  • Naoko Watanabe
  • Akiko Matsushita
  • Akinori Maeda
  • Kenichi Nagai
  • Akiko Sada
  • Toshimitsu Matsui
  • Takayuki Takahashi
Case Report

Abstract

Hypereosinophilic syndrome (HES) was diagnosed in December 2000 in a 43-year-old man on the basis of persistent eosinophilia (11.7 x 109/L) and a normal karyotype of the bone marrow cells. He had developed intra-abdominal non-Hodgkin’s lymphoma and in 1992 had received 3 courses of combination chemotherapy with doxorubicin (Adriamycin), cyclophosphamide, vincristine, methotrexate, bleomycin, and prednisolone. The patient was orally given prednisolone (10 mg/day) and cyclophosphamide (50 mg/day) as HES treatment without a subsequent improvement of the eosinophilia. In May 2003, anemia (hemoglobin, 7.9 g/dL) and thrombocytopenia (65 x 109/L) manifested with progressive eosinophilia (21.0 ×109/L) and a small number of blasts. The patient became febrile and was admitted in July 2003. Cytogenetic reexamination of the bone marrow cells disclosed the deletion of 4q12, indicating the presence of a fusion of the Fip1-like 1 (FIP1L1) gene to the plateletderived growth factor receptor α (PDGFRα) gene and consequently the clonal nature of his hematopoietic cells. DNA sequence analysis demonstrated that the breakpoints of the FIP1L1 and PDGFRα genes were present in exon 9 and exon 12, respectively. Treatment with imatinib mesylate (300 mg/day) promptly brought about complete remission. Although a number of similar eosinophilic cases have been reported, our patient may be the first such patient with a history of chemotherapy.

Key words

Chronic eosinophilic leukemia Hypereosinophilic syndrome Secondary leukemia Imatinib mesylate FIP1L1-PDGFR “&” fusion gene 

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Copyright information

© The Japanese Society of Hematology 2006

Authors and Affiliations

  • Yasuhiro Tanaka
    • 1
  • Masayuki Kurata
    • 1
  • Katsuhiro Togami
    • 1
  • Haruyuki Fujita
    • 1
  • Naoko Watanabe
    • 1
  • Akiko Matsushita
    • 1
  • Akinori Maeda
    • 1
  • Kenichi Nagai
    • 1
  • Akiko Sada
    • 2
  • Toshimitsu Matsui
    • 2
  • Takayuki Takahashi
    • 1
  1. 1.Department of Hematology and Clinical ImmunologyKobe City General HospitalKobeJapan
  2. 2.Division of Endocrinology/Metabolism, Neurology, and Hematology/OncologyDepartment of Clinical Molecular Medicine, Kobe University Graduate School of MedicineKobeJapan

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