Papadakis Stavros, Liapis Ioannis, Papadhimitriou Stefanos I, Spanoudakis Emmanouil, Kotsianidis Ioannis, Liapis Konstantinos
Department of Hematology, University Hospital of Heraklion, 711 10 Heraklion, Greece.
Department of Hematology, Aghios Georgios Hospital, 733 00 Chania, Greece.
J Clin Med. 2024 Feb 2;13(3):876. doi: 10.3390/jcm13030876.
There is remarkable morphologic and genetic heterogeneity in acute myeloid leukemia (AML). In a small percentage of cases of AML, increased eosinophils and/or basophils are present in the bone marrow and sometimes in the peripheral blood. This is often a puzzling diagnostic situation but also an important finding that requires special investigation. Unique chromosomal rearrangements have been correlated with an increased number of eosinophils and basophils in AML. The identification of the underlying genetic lesion that promotes eosinophilia and basophilia can dramatically change both the prognosis and the treatment of the patient. Thus, clinicians must be vigilant in searching for the cause of eosinophilia and basophilia in patients with AML, since the different causes may lead to different treatments and survival outcomes. In this article, we examine the significance of increased eosinophils and/or basophils in the context of AML, provide guidance that simplifies the differential diagnosis, and give prognostic and therapeutic information about specific subtypes of AML associated with eosinophilia and/or basophilia. Evidence supporting personalized (molecularly targeted) therapy for these patients is also presented.
急性髓系白血病（AML）存在显著的形态学和基因异质性。在一小部分AML病例中，骨髓中会出现嗜酸性粒细胞和/或嗜碱性粒细胞增多，外周血中有时也会如此。这常常是一种令人困惑的诊断情况，但也是一项需要进行特殊调查的重要发现。独特的染色体重排与AML中嗜酸性粒细胞和嗜碱性粒细胞数量增加相关。识别导致嗜酸性粒细胞增多和嗜碱性粒细胞增多的潜在基因病变可显著改变患者的预后和治疗方案。因此，临床医生必须警惕在AML患者中寻找嗜酸性粒细胞增多和嗜碱性粒细胞增多的原因，因为不同的原因可能导致不同的治疗方法和生存结果。在本文中，我们探讨了AML背景下嗜酸性粒细胞和/或嗜碱性粒细胞增多的意义，提供简化鉴别诊断的指导，并给出与嗜酸性粒细胞增多和/或嗜碱性粒细胞增多相关的AML特定亚型的预后和治疗信息。本文还展示了支持对这些患者进行个性化（分子靶向）治疗的证据。
