The Association of Eosinophilia with Lymphoblastic Leukaemia or Lymphoma: a Study of Seven Patients

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Abstract
Seven patients with hypereosinophilia in association with a lymphoblastic malignancy are described. The eosinophilia preceded or was present at diagnosis in all patients. Eosinophil counts fell during complete remission but rose significantly before or during relapses in 5 patients. Hypogranular and sometimes Pelger-cosinophils were seen in 5 cases. Surface and enzyme markers defined the malignancy in 6 cases as common-ALL [acute lymphoblastic leukemia] (3), T cell-ALL (2) and T cell-lymphoblastic lymphoma (1). Although a diagnosis of eosinophilic leukemia or acute myeloid leukemia with eosinophil differentiation was considered in 3 patients, cytochemical and ultrastructural studies failed to show any evidence of myeloid differentiation in the blast cells. The bone marrow karotype was normal in the 4 patients studied. All 7 patients had 1 or more relapse; 6 died 6-62 mo. from diagnosis. Severe complications of the hypereosinophilic syndrome developed in 1 patient. As T lymphocytes have been shown to be involved in the induction of eosinophilia in rodents, it is suggested that the hypereosinophilia in these patients was induced by eosinopoietic stimuli produced by lymphoblasts.