Abnormal eosinophil count at CLL diagnosis correlates with shorter treatment free survival

Egholm, Guðrun Jákupsdóttir; Andersen, Michael Asger; Andersen, Christen Lykkegaard; Frederiksen, Henrik; Bjerrum, Ole Weis; Niemann, Carsten Utoft

doi:10.1111/bjh.17264

Cited by 2 publications

(3 citation statements)

References 12 publications

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“…However, they have also been implicated in many other disorders, such as specific organ damage in localized infiltrative eosinophilic entities. [43][44][45] In our study, having heart disease, stroke, and/or metabolic disease were independently associated with B-Eos count in adults, similar to previous findings. 27 This indicates that other diseases than respiratory diseases must be considered when using B-Eos count in the management of asthma and COPD.…”

Section: Discussionsupporting

confidence: 91%

“…Eosinophils play a major role in mediating allergic inflammation. However, they have also been implicated in many other disorders, such as specific organ damage in localized infiltrative eosinophilic entities 43–45 . In our study, having heart disease, stroke, and/or metabolic disease were independently associated with B‐Eos count in adults, similar to previous findings 27 .…”

Section: Discussionsupporting

confidence: 90%

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The influence of individual characteristics and non‐respiratory diseases on blood eosinophil count

Amaral

Jacinto

Malinovschi

et al. 2021

Clinical & Translational All

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Background Blood eosinophil (B‐Eos) count is an emerging biomarker in the management of respiratory disease but determinants of B‐Eos count besides respiratory disease are poorly described. Therefore, we aimed to evaluate the influence of non‐respiratory diseases on B‐Eos count, in comparison to the effect on two other biomarkers: fraction of exhaled nitric oxide (FeNO) and C‐reactive protein (CRP), and to identify individual characteristics associated with B‐Eos count in healthy controls. Methods Children/adolescents (<18 years) and adults with complete B‐Eos data from the US National Health and Nutritional Examination Surveys 2005–2016 were included, and they were divided into having respiratory diseases (n = 3333 and n = 7,894, respectively) or not having respiratory disease (n = 8944 and n = 15,010, respectively). After excluding any respiratory disease, the association between B‐Eos count, FeNO or CRP, and non‐respiratory diseases was analyzed in multivariate models and multicollinearity was tested. After excluding also non‐respiratory diseases independently associated with B‐Eos count (giving healthy controls; 8944 children/adolescents and 5667 adults), the independent association between individual characteristics and B‐Eos count was analyzed. Results In adults, metabolic syndrome, heart disease or stroke was independently associated with higher B‐Eos count (12%, 13%, and 15%, respectively), whereas no associations were found with FeNO or CRP. In healthy controls, male sex or being obese was associated with higher B‐Eos counts, both in children/adolescents (15% and 3% higher, respectively) and adults (14% and 19% higher, respectively) (p < 0.01 all). A significant influence of race/ethnicity was also noted, and current smokers had 17% higher B‐Eos count than never smokers (p < 0.001). Conclusions Non‐respiratory diseases influence B‐Eos count but not FeNO or CRP. Male sex, obesity, certain races/ethnicities, and current smoking are individual characteristics or exposures that are associated with higher B‐Eos counts. All these factors should be considered when using B‐Eos count in the management of respiratory disease.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 90%

The influence of individual characteristics and non‐respiratory diseases on blood eosinophil count

Amaral

Jacinto

Malinovschi

et al. 2021

Clinical & Translational All

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“…Moreover, the collaboration between the two MDTs in Denmark supports the possibility of participating in international clinical trials, e.g., in iHES ( Table 2 ), because the potential number of patients to be included is higher than in the individual centers. The accumulation and interest of patients with eosinophilia in MDTs facilitate research, e.g., cohort studies in chronic lymphocytic leukemia demonstrating the impact of eosinophilia at diagnosis ( 183 ) and a retrospective study advocating PCR analysis for T-cell receptor status in the diagnostic workup ( Figures 2 , 3 ), to be performed only if clonality has been demonstrated by flow analysis of lymphocyte subpopulations in blood or bone marrow samples ( 67 ).…”

Section: Discussionmentioning

confidence: 99%

The multidisciplinary approach to eosinophilia

et al. 2023

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Eosinophilic granulocytes are normally present in low numbers in the bloodstream. Patients with an increased number of eosinophilic granulocytes in the differential count (eosinophilia) are common and can pose a clinical challenge because conditions with eosinophilia occur in all medical specialties. The diagnostic approach must be guided by a thorough medical history, supported by specific tests to guide individualized treatment. Neoplastic (primary) eosinophilia is identified by one of several unique acquired genetic causes. In contrast, reactive (secondary) eosinophilia is associated with a cytokine stimulus in a specific disease, while idiopathic eosinophilia is a diagnosis by exclusion. Rational treatment is disease-directed in secondary cases and has paved the way for targeted treatment against the driver in primary eosinophilia, whereas idiopathic cases are treated as needed by principles in eosinophilia originating from clonal drivers. The vast majority of patients are diagnosed with secondary eosinophilia and are managed by the relevant specialty—e.g., rheumatology, allergy, dermatology, gastroenterology, pulmonary medicine, hematology, or infectious disease. The overlap in symptoms and the risk of irreversible organ involvement in eosinophilia, irrespective of the cause, warrants that patients without a diagnostic clarification or who do not respond to adequate treatment should be referred to a multidisciplinary function anchored in a hematology department for evaluation. This review presents the pathophysiology, manifestations, differential diagnosis, diagnostic workup, and management of (adult) patients with eosinophilia. The purpose is to place eosinophilia in a clinical context, and therefore justify and inspire the establishment of a multidisciplinary team of experts from diagnostic and clinical specialties at the regional level to support the second opinion. The target patient population requires highly specialized laboratory analysis and therapy and occasionally has severe eosinophil-induced organ dysfunction. An added value of a centralized, clinical function is to serve as a platform for education and research to further improve the management of patients with eosinophilia. Primary and idiopathic eosinophilia are key topics in the review, which also address current research and discusses outstanding issues in the field.

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Abnormal eosinophil count at CLL diagnosis correlates with shorter treatment free survival

Cited by 2 publications

References 12 publications

The influence of individual characteristics and non‐respiratory diseases on blood eosinophil count

The influence of individual characteristics and non‐respiratory diseases on blood eosinophil count

The multidisciplinary approach to eosinophilia

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