PMID: 8603011Feb 1, 1996Paper

Hypereosinophilia during 2-chlorodeoxyadenosine treatment for hairy cell leukaemia

British Journal of Haematology
S RutellaC Peschle

Abstract

A 43-year-old male with newly diagnosed hairy cell leukaemia underwent a single course of 2-chlorodeoxyadenosine (2-CdA). Skin rash, facial swelling and marked eosinophilia developed 20 d after treatment and were resolved by 7 d of steroid therapy. Eosinophil peak in peripheral of the eosinophil population showed a high expression of the IL-2 receptor alpha-chain (CD25), representing up to 94% of gated cells. HLA-DR and CD4 antigens were constantly negative; eosinophils strongly reacted with the secretory form of the eosinophil cationic protein (ECP), recognized by EG2 monoclonal antibody. IL-5 serum levels were markedly elevated at the onset of eosinophilia, returned to normal levels after its disappearance and positively correlated with eosinophil count (r = 0.94, P = 0.016). Eosinophilia is an uncommon finding after treatment with 2-CdA. It is unclear whether these phenomena represented a true allergic reaction to the drug or the effect of massive tumour cell lysis and haemopoietic pancytopenia with immunosuppression, which induced the release of IL-5 and possibly other cytokines.

Citations

Dec 22, 1998·Annals of Allergy, Asthma & Immunology : Official Publication of the American College of Allergy, Asthma, & Immunology·A TsukadairaM Sekiguchi
Nov 1, 2011·Leukemia & Lymphoma·Chezi GanzelNeta Goldschmidt
Aug 25, 2004·Journal of the European Academy of Dermatology and Venereology : JEADV·M S RossiniI Lorand-Metze

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