文章：

嗜酸性粒细胞增多性血液系统肿瘤

Hematological Neoplasms with Eosinophilia

原文发布日期：12 January 2024

DOI: 10.3390/cancers16020337

类型: Article

开放获取: 是

英文摘要：

Eosinophils in peripheral blood account for 0.3–5% of leukocytes, which is equivalent to 0.05–0.5 × 109/L. A count above 0.5 × 109/L is considered to indicate eosinophilia, while a count equal to or above 1.5 × 109/L is defined as hypereosinophilia. In bone marrow aspirate, eosinophilia is considered when eosinophils make up more than 6% of the total nuclear cells. In daily clinical practice, the most common causes of reactive eosinophilia are non-hematologic, whether they are non-neoplastic (allergic diseases, drugs, infections, or immunological diseases) or neoplastic (solid tumors). Eosinophilia that is associated with a hematological malignancy may be reactive or secondary to the production of eosinophilopoietic cytokines, and this is mainly seen in lymphoid neoplasms (Hodgkin lymphoma, mature T-cell neoplasms, lymphocytic variant of hypereosinophilic syndrome, and B-acute lymphoblastic leukemia/lymphoma). Eosinophilia that is associated with a hematological malignancy may also be neoplastic or primary, derived from the malignant clone, usually in myeloid neoplasms or with its origin in stem cells (myeloid/lymphoid neoplasms with eosinophilia and tyrosine kinase gene fusions, acute myeloid leukemia with core binding factor translocations, mastocytosis, myeloproliferative neoplasms, myelodysplastic/myeloproliferative neoplasms, and myelodysplastic neoplasms). There are no concrete data in standardized cytological and cytometric procedures that could predict whether eosinophilia is reactive or clonal. The verification is usually indirect, based on the categorization of the accompanying hematologic malignancy. This review focuses on the broad differential diagnosis of hematological malignancies with eosinophilia.

摘要翻译： 

外周血中嗜酸性粒细胞占白细胞总数的0.3–5%，相当于0.05–0.5 × 10⁹/L。计数超过0.5 × 10⁹/L被视为嗜酸性粒细胞增多，而计数达到或超过1.5 × 10⁹/L则定义为高嗜酸性粒细胞增多症。在骨髓穿刺涂片中，当嗜酸性粒细胞占核细胞总数超过6%时，即考虑为嗜酸性粒细胞增多。在日常临床实践中，反应性嗜酸性粒细胞增多最常见的原因是非血液系统疾病，无论是非肿瘤性（过敏性疾病、药物、感染或免疫性疾病）还是肿瘤性（实体肿瘤）。与血液系统恶性肿瘤相关的嗜酸性粒细胞增多可能是反应性的，或继发于嗜酸性粒细胞生成细胞因子的产生，这主要见于淋巴系统肿瘤（霍奇金淋巴瘤、成熟T细胞肿瘤、高嗜酸性粒细胞综合征的淋巴细胞变异型以及B细胞急性淋巴细胞白血病/淋巴瘤）。与血液系统恶性肿瘤相关的嗜酸性粒细胞增多也可能是肿瘤性或原发性的，源自恶性克隆，通常见于髓系肿瘤或起源于干细胞的肿瘤（伴嗜酸性粒细胞增多和酪氨酸激酶基因融合的髓系/淋巴系肿瘤、伴核心结合因子易位的急性髓系白血病、肥大细胞增多症、骨髓增殖性肿瘤、骨髓增生异常/骨髓增殖性肿瘤以及骨髓增生异常肿瘤）。目前尚无标准化的细胞学和细胞计量学程序中的具体数据能够预测嗜酸性粒细胞增多是反应性的还是克隆性的。验证通常是间接的，基于伴随的血液系统恶性肿瘤的分类。本综述重点讨论伴有嗜酸性粒细胞增多的血液系统恶性肿瘤的广泛鉴别诊断。

原文链接：

Hematological Neoplasms with Eosinophilia