Abnormal Clones of T Cells Producing Interleukin-5 in Idiopathic Eosinophilia

Simon, Hans‐Uwe; Plötz, Sabine G.; Dummer, Reinhard; Blaser, Kurt

doi:10.1056/nejm199910073411503

Cited by 436 publications

(362 citation statements)

References 22 publications

Supporting

Mentioning

332

Contrasting

Unclassified

Order By: Relevance

“…30 Since that time, several large series of L-HES patients have been reported. 16,[31][32][33][34] Although listed as an exclusion criteria for a diagnosis of idiopathic HES, L-HES is not otherwise classified in the 2008 WHO guidelines. 5 Equally frequent in men and women, L-HES is characterized by a high prevalence of skin and soft tissue manifestations, elevated serum IgE, and thymus and activation regulated chemokine levels.…”

Section: Myeloproliferative He/hes (M-he or M-hes; He Or Hes With Docmentioning

confidence: 99%

How I treat hypereosinophilic syndromes

Klion

2015

Blood

199

126

View full text Add to dashboard Cite

Hypereosinophilic syndromes (HESs) are a group of rare disorders characterized by peripheral blood eosinophilia of 1.5 × 109/L or higher and evidence of end organ manifestations attributable to the eosinophilia and not otherwise explained in the clinical setting. HESs are pleomorphic in clinical presentation and can be idiopathic or associated with a variety of underlying conditions, including allergic, rheumatologic, infectious, and neoplastic disorders. Moreover, the etiology of the eosinophilia in HESs can be primary (myeloid), secondary (lymphocyte-driven), or unknown. Although corticosteroids remain the first-line therapy for most forms of HESs, the availability of an increasing number of novel therapeutic agents, including tyrosine kinase inhibitors and monoclonal antibodies, has necessarily altered the approach to treatment of HESs. This review presents an updated treatment-based approach to the classification of patients with presumed HES and discusses the roles of conventional and novel agents in the management of these patients.

show abstract

Section: Myeloproliferative He/hes (M-he or M-hes; He Or Hes With Docmentioning

confidence: 99%

How I treat hypereosinophilic syndromes

Klion

2015

Blood

199

126

View full text Add to dashboard Cite

show abstract

“…For example, T cell clones producing the characteristic Th2 cytokines, IL-4 and IL-5, have been found in patients satisfying the diagnostic criteria for HES. [63,64] However, perhaps the most striking advance in our understanding of HES has resulted from treatment of HES patients with the tyrosine kinase inhibitor, imatinib mesylate. [65][66][67][68][69] Imatinib was introduced for the treatment of chronic myelogenous leukemia and has had a remarkable effect in that disease.…”

Section: Gastrointestinal Eosinophilia In Hypereosinophilic Syndrome mentioning

confidence: 99%

Gastrointestinal Eosinophilia

Zuo

Rothenberg

2007

Immunology and Allergy Clinics of North America

View full text Add to dashboard Cite

“…Further research should reveal the meaning of the clonal T-cell population in BM. Because patients diagnosed with idiopathic HES and associated clonal T-cell populations are at risk of developing T-cell lymphoma, 19,22,23 careful follow-up is required in this case. Case 18 was admitted to our hospital in 1994 and was diagnosed with CD30 ϩ cutaneous T-cell lymphoma.…”

Section: Evaluation Of Tcr Clonality As Demonstrated By Pcr Analysis mentioning

confidence: 99%

BIOMED-2 Multiplex Immunoglobulin/T-Cell Receptor Polymerase Chain Reaction Protocols Can Reliably Replace Southern Blot Analysis in Routine Clonality Diagnostics

Sandberg

Gastel-Mol

Verhaaf

et al. 2005

The Journal of Molecular Diagnostics

View full text Add to dashboard Cite

To establish the most sensitive and efficient strategy of clonality diagnostics via immunoglobulin and Tcell receptor gene rearrangement studies in suspected lymphoproliferative disorders, we evaluated 300 samples (from 218 patients) submitted consecutively for routine diagnostics. All samples were studied using the BIOMED-2 multiplex polymerase chain reaction (PCR) protocol. In 176 samples, Southern blot (SB) data were also available, and the two types of molecular results were compared. Results of PCR and SB analysis of both T-cell receptor and immunoglobulin loci were concordant in 85% of samples. For discordant results, PCR results were more consistent with the final diagnosis in 73% of samples. No false-negative results were obtained by PCR analysis. In contrast, SB analysis failed to detect clonality in a relatively high number of samples, mainly in cases of low tumor burden. We conclude that the novel BIOMED-2 multiplex PCR strategy is of great value in diagnosing patients with suspected B-and T-cell proliferations. Because of its higher speed, efficiency, and sensitivity, it can reliably replace SB analysis in clonality diagnostics in a routine laboratory setting. In most patients with suspected lymphoproliferative disorders, discrimination between reactive and malignant cell populations can be assessed by histomorphology or cytomorphology supplemented with immunohistochemistry or flow cytometric immunophenotyping. However, in 5 to 10% of patients, diagnosis is more complicated and less straightforward. In such cases, molecular gene rearrangement studies have proved useful as an additional diagnostic tool. Molecular clonality analysis is based on the fact that, in principle, all cells of a malignancy have a common clonal origin and show clonally (identically) rearranged immunoglobulin (Ig) or T-cell receptor (TCR) genes. The diagnosis of malignant B-and T-cell proliferations is therefore supported by the finding of Ig/TCR gene clonality, whereas reactive lymphoproliferations show polyclonally rearranged Ig/TCR genes. 1 Gene rearrangement analysis can be performed by Southern blot (SB)-and polymerase chain reaction (PCR)-based techniques. Despite the high reliability of SB analysis, it is increasingly replaced by PCR techniques because of the greater efficiency and sensitivity of PCR. Moreover, PCR is relatively easy, less labor intensive, and requires much less high-molecular-weight DNA. Also, SB analysis cannot be performed on paraffinembedded tissue because the isolated DNA is often degraded. Therefore, there is a strong need to replace SB analysis with reliable PCR techniques. However, PCR studies have often suffered from false-negative results due to improper annealing of primers and/or the presence of somatic hypermutation. 2 Both SB and PCR analyses of the immunoglobulin heavy chain (IGH) locus have been demonstrated to be very useful and reliable techniques in clonality assessment of suspected B-cell malignancies. However, the most useful gene target for identifying T-cell clonality is less well e...

show abstract

Abnormal Clones of T Cells Producing Interleukin-5 in Idiopathic Eosinophilia

Abstract: Clonal populations of abnormal T cells producing interleukin-5 occur in some patients with idiopathic eosinophilia.

Cited by 436 publications

References 22 publications

How I treat hypereosinophilic syndromes

How I treat hypereosinophilic syndromes

Gastrointestinal Eosinophilia

BIOMED-2 Multiplex Immunoglobulin/T-Cell Receptor Polymerase Chain Reaction Protocols Can Reliably Replace Southern Blot Analysis in Routine Clonality Diagnostics

Contact Info

Product

Resources

About