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Predictors of survival in WHO-defined hypereosinophilic syndrome and idiopathic hypereosinophilia and the role of next-generation sequencing

Leukemia volume 30, pages 1924–1926 (2016)Cite this article

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The natural history of primary eosinophilic disorders remains poorly defined, given the underlying disease heterogeneity.1 The WHO (World Health Organization) classification of primary eosinophilias includes: (i) myeloid and lymphoid neoplasms with eosinophilia and recurrent abnormalities of PDFRA, PDGFRB or FGFR1;2 (ii) chronic eosinophilic leukemia-not otherwise specified, characterized by presence of other cytogenetic/clonal abnormalities and/or presence of excess blasts in peripheral blood or bone marrow;3 and (iii) lymphocyte-variant primary eosinophilia, characterized by occult expansion of immunophenotypically aberrant T-lymphocytes that produce cytokines such as interleukin-5.3, 4 Patients not fitting the three aforementioned subgroups are classified as idiopathic hypereosinophilia (IHE), including idiopathic hypereosinophilic syndrome (HES) when additional criteria including end-organ/tissue damage from tissue eosinophilia are satisfied. The goal of the current study was to identify predictors of inferior overall survival (OS) in HES/IHE patients including relevant molecular parameters using next-generation sequencing.

The current study was approved by our institutional review board. Consecutive patients with peripheral blood and bone marrow eosinophilia who met WHO criteria for HES/IHE were retrospectively identified,3 with the proviso that, consistent with recent consensus guidelines,5 persistence of peripheral blood hypereosinophilia for a minimum 6 month period was not required for those with symptoms requiring treatment within that time frame. The presence of eosinophilia-related end-organ dysfunction was based on clinical, radiological and/or pathology assessments. Inclusion criteria included availability of archived bone marrow aspirate samples for DNA extraction.

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Acknowledgements

Mayo Clinic (Rochester) sequencing core facility.

Author contributions

TL, AT and AP designed the project and analyzed the data. CF performed sample preparation for sequencing. TL analyzed the sequencing data. DZ contributed patient samples for the study. EW and NG abstracted data from medical charts. CAH assisted in pathology review. RPK assisted in cytogenetics review. AP wrote the first draft of the paper. All the authors reviewed the manuscript draft, provided critical input and approved the final version of the manuscript. TL and AP had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

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Authors and Affiliations

  1. Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, MN, USA

    A Pardanani, T Lasho, E Wassie, C Finke, D Zblewski, N Gangat & A Tefferi

  2. Division of Hematopathology, Mayo Clinic, Rochester, MN, USA

    C A Hanson

  3. Department of Laboratory Medicine and Pathology, Cytogenetics, Mayo Clinic, Rochester, MN, USA

    R P Ketterling

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  1. A Pardanani
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Correspondence to A Pardanani.

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Pardanani, A., Lasho, T., Wassie, E. et al. Predictors of survival in WHO-defined hypereosinophilic syndrome and idiopathic hypereosinophilia and the role of next-generation sequencing. Leukemia 30, 1924–1926 (2016). https://doi.org/10.1038/leu.2016.73

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