Association of the blood eosinophil count with hematological malignancies and mortality

Abstract

Blood eosinophilia (≥0.5 × 109/l) may be an early sign of hematological malignancy. We investigated associations between levels of blood eosinophils and risks of hematological malignancies and mortality in order to provide clinically derived cut‐offs for referral to specialist hematology care. From the Copenhagen Primary Care Differential Count (CopDiff) Database, we identified 356,196 individuals with at least one differential cell count encompassing the eosinophil count during 2000–2007 and matched these laboratory data with Danish nationwide health registers. We used multivariable logistic regression to calculate odds ratios (ORs) for the 4‐year incidences of hematological malignancies and mortality between the eosinophil counts and a reference count of 0.16 × 109/l which was the median eosinophil count in our data. Risks of hematological malignancies and mortality increased above the median eosinophil count. At the 99th percentile, corresponding to an eosinophil count of 0.75 × 109/l, risks of hematological malignancies were increased more than twofold with OR (95% C.I.) of 2.39 (1.91–2.99). Interestingly, risks reached a plateau around an eosinophil count of 1.0 × 109/l. Risks also increased when the eosinophil count approached zero. Here, counts associated relatively more with acute myeloid leukemia and myelodysplastic syndromes whereas counts above 0.16 × 109/l associated more with myeloproliferative neoplasms. Eosinophil counts associate with hematological malignancies and mortality even below the definition of eosinophilia. The observed plateau of risks around 1.0 × 109/l is important for physicians encountering patients with eosinophilia since even mild‐to‐moderate eosinophilia according to traditional definitions confers maximally increased risks of subsequent/subclinical hematological malignancy. Am. J. Hematol. 90:225–229, 2015. © 2014 Wiley Periodicals, Inc.

Hypereosinophilia-and-Intraoperative-Complications-under-General-Anesthesia-in-Surgical-Patients-Aged-12-Years-or-More-an-Observation

“…1.68 %) in the present study. On the other hand, a study done in Copenhagen found only 4% eosinophilia which is lower than the present study [10] . Another multicentre retrospective analysis from United States found eosinophilia in 6 % patients as incidental finding [11] .…”

Guideline for the investigation and management of eosinophilia

“…Rheumatoid arthritis (RA): a recent prospective French study showed that approximately 3% of patients with RA have an eosinophilia, which is usually mild and transient (Guellec et al, 2015). Although this prevalence does not differ from that of the Danish population study, defined in the same manner (Andersen et al, 2015), eosinophilia did appear to predict a poorer response to disease-modifying antirheumatic drug use after 3 years (Guellec et al, 2015). A smaller Argentinian study demonstrated a 7% prevalence of eosinophilia amongst RA patients, but in all these cases a parasitic cause for the eosinophilia was subsequently demonstrated (Chiardola et al, 2008).…”

“…Primary and idiopathic eosinophil disorders are rare and probably under‐diagnosed conditions. A large population based study in a general practice setting from Copenhagen demonstrated an incidence of eosinophilia (defined as a count of at least 0·5 × 10 9 /l) of 4% (Andersen et al , ).…”

White cell counts in relation to mortality in a general population of cohort study in the Netherlands: a mediating effect or not?

“…Several studies have shown that monocyte counts have been independently associated with all-cause,2 20 CVD2 21 or cancer-related mortality,2 20 while other studies have reported no association 3 22. A U-shaped association of eosinophil count with all-cause mortality was reported in a Danish study 23. Smoking or obesity has been associated with differential WCC subtype,24 25 while whether this impacts mortality differently is unknown.…”