Clonal involvement of eosinophils in therapy‐related myelodysplastic syndrome with eosinophilia, translocation t(1;7) and lung cancer

Abstract

We report a therapy-related MDS (RAEB) patient with eosinophilia, unbalanced translocation der(7)t(1;7) (q12;q22) and lung cancer. We observed no increase in cytokine levels in serum or in the conditioned medium (CM) of peripheral T cells cultured with or without IL-2. When bone marrow (BM) cells were cultured with GM-CSF, IL-3 and SCF in a semisolid system, the colonies were exclusively eosinophilic. Cytogenetic analysis of the colony cells identified the same chromosome abnormality in all metaphases to that of BM cells. Suspension and clonogenic colony assay of BM cells cultured with various cytokines showed predominant eosinophilic growth and differentiation with GM-CSF, but not with the other cytokines examined. These findings, together with mild morphological abnormalities of eosinophils, indicate clonal involvement of eosinophils in the myelodysplastic syndrome (MDS) clone, and that the eosinophilia was derived from the neoplastic clone with the translocation and was not associated with the patient's lung cancer.

Myelodysplastic Syndrome with Clonal Eosinophilia Accompanied by Eosinophilic Pulmonary Interstitial Infiltration

“…Therefore, the diagnosis of MDS-Eo requires careful exclusion of other hematological disorders. To our knowledge, clonal eosinophilia with MDS has been previously reported in 5 cases [2, 3, 4, 5, 6]. In the case presented here, chromosomal aberration was identified in eosinophilic metaphase spreads by means of simple Giemsa staining, thus indicating that eosinophilia in our case was clonal proliferation.…”

“…Eosinophilia also occurs in association with MDS and this condition has been termed MDS with eosinophilia or eosinophilic MDS (MDS-Eo) [1]. Cytogenetically proven clonal proliferation of eosinophils has been reported in 5 previous MDS-Eo patients [2, 3, 4, 5, 6]. …”

Unbalanced translocation der(1;7)(q10;p10) defines a unique clinicopathological subgroup of myeloid neoplasms

“…In both groups, more cases are diagnosed as MDS than as AML. Increased eosinophil counts in der(1;7)(q10;p10) have been underscored in some literatures, 13,24,25 but in our series it was not so conspicuous and only six der(1;7)(q10;p10) and one -7/7q-cases had prominent eosinophilia (4450/ml).…”

“…10 On the other hand, however, the clinical aspect of this translocation is less clearly defined compared with its genomic structure. While the common clinical features thus far reported include a previous history of chemo-and/or radiotherapies in more than half cases, [11][12][13] presence of eosinophilia, 13 trilineage dysplasia, high rates of progression to AML in MDS cases and poor prognosis with less than 1 year of median survival, 3,14,15 these features have not been fully investigated because of the rarity of this translocation compared with other well-characterized cytogenetic groups found in AML/MDS. Also it is unclear that its pathogenetic link to monosomy 7 or partial deletion of 7q (À7/7q-) other than der(1;7)(q10;p10), although some authors speculated that der(1;7)(q10;p10) represents a mere variant of the former.…”

Prevalence and clinical characteristics of myelodysplastic syndrome with bone marrow eosinophilia or basophilia

“…11,13,[21][22][23][24][25][26][27] In each case, researchers have attempted to delineate the specific clinical features of these cases. However, the lack of any large-scale study has made it difficult to actually determine the prevalence and clinical significance of bone marrow eosinophilia and basophilia in patients with MDS.…”