Acute lymphoblastic leukemia with chromosomal 5;14 translocation and hypereosinophilia: case report and literature review.

Abstract

A 19-year-old man with acute lymphoblastic leukemia (ALL) presented with 82,000 WBC/microL, 57% eosinophils, and cardiorespiratory symptoms. Lymphoblast infiltration of the meninges and testes developed without eosinophil infiltration at these sites and peripheral blood and marrow lymphoblast counts progressively increased, while blood eosinophilia disappeared. The patient's bone marrow cells had a clonal cytogenetic abnormality--t(5;14), (q?,q32)--which disappeared during remission and reappeared during disease relapse. Including this case, three patients with ALL and hypereosinophilia have had cytogenetic studies with G-banding. All three had 14q + chromosomal abnormalities and two had a similar translocation t(5,14), (q?,q32). Survival of the 26 ALL patients with hypereosinophilia reported since 1973 was similar to that of 52 age- and sex-matched historical-control patients without hypereosinophilia treated during the same time interval.

Calla-Positive Acute Leukaemia with t(5q;14q) Translocation and Hypereosinophilia – A Unique Entity?

“…14 (14q+) and an extra C-group chromosome. In 2 patients reported by Tono-oka et al [20] and Hogan et al [21] a t(5q;14q) translocation was found, a finding which is identical to that seen in our patient [20,21].…”

“…Vari able aneuploidy was described 3 times [6,16,19]. In 3 further cases marker chromosomes or translocations were determined by means of the banding technique [10,20,21]. Chilcote et al [10] published a case which was characterized by a marker on the long arm of chromosome No.…”

“…(1) In 13 cases hypereosinophilia was present be fore a bone marrow failure was visible in the blood [5][6][7][8][9][10][11][12][14][15][16][17], (2) Frequent clinical findings due to eosinophilic infiltrations of involved organs were cough, shortness of breath, skin rash, dysaesthesia and cardiac mal function [6,8,11,12,14,15,[17][18][19][20][21].…”

Hypereosinophilia in Acute Lymphoblastic Leukemia: Two Cases with Review of Literature

“…AML with t [16] or inversion 16 are common genetic abnormalities associated with eosinophilia [6,7]. Most common genetic abnormality detected in case of ALL associated with eosinophilia is t [5,14] which is otherwise uncommon in classical cases of ALL [2,3,[8][9][10]. In general, eosinophilia in association with ALL is rare and that too in T-cell subtype, it is limited to case reports [11][12][13][14].…”

“…ALL associated eosinophilia was first reported by Spitzer et al [1]. Some studies have reported association of chromosomal anomaly t [5,14] with eosinophilia associated ALL [2,3]. Whether reactive or clonal, eosinophilia always endangers vital organs at risk of dysfunction.…”