HES及克隆性嗜酸性粒細(xì)胞增多癥

單擊此處編輯母版標(biāo)題樣式,單擊此處編輯母版文本樣式,第二級(jí),第三級(jí),第四級(jí),第五級(jí),高嗜酸性粒細(xì)胞綜合癥及嗜酸性粒細(xì)胞增多癥：診斷要點(diǎn)和治療進(jìn)展,Tefferi A,Gotlib J,Pardanani A.Hypereosinophilic syndrome and clonal eosinophilia:point-of-care diagnostic algorithm and treatment update.Mayo Clin Proc.2010;85(2):158-64.,Acquired eosinophilia,Acquired eosinophilia,is operationally categorized into secondary,clonal,and idiopathic types.,Causes of,secondary eosinophilia,include parasite infections,allergic or vasculitis conditions,drugs,and lymphoma.,Clonal,eosinophilia,is distinguished from idiopathic eosinophilia by the presence of histologic,cytogenetic,or molecular evidence of an underlying myeloid malignancy.,獲得性嗜酸性粒細(xì)胞增多癥,獲得性,嗜酸性粒細(xì)胞增多癥被人為的分為繼發(fā)性,克隆性和特發(fā)性,三種類(lèi)型,。,繼發(fā)性,嗜酸性粒細(xì)胞增多的原因包括：寄生蟲(chóng)感染、過(guò)敏或血管炎,藥物和淋巴瘤。,克隆性,嗜酸性粒細(xì)胞增多是區(qū)別于特發(fā)性嗜酸性粒細(xì)胞增多的，通過(guò)組織學(xué)、細(xì)胞遺傳學(xué)、或潛在的髓系惡性增生的分子證據(jù)。,C,lonaleosinophilia,The World Health Organization classification system for hematologic malignancies recognizes,2 distinct subcategories,ofclonaleosinophilia:chronic eosinophilic leukemia,not otherwise specified (,CEL-NOC,),and,myeloid/lymphoid neoplasms,with eosinophilia and mutations involving platelet-derived growth factor receptor alpha/beta(PDGFRA or PDGFRB),or fibroblast growth factor receptor 1,(FGFR1),.,克隆性嗜酸性粒細(xì)胞增多癥,世界衛(wèi)生組織惡性血液病分類(lèi)系統(tǒng)將,克隆,性,嗜酸性粒細(xì)胞增多癥分為,2個(gè),不同的,亞型,：未另行規(guī)定,的,慢性嗜酸性白血病和伴有血小板源生長(zhǎng)因子受體/或纖維母細(xì)胞生長(zhǎng)因子受體1基因突變的髓系/淋巴系腫瘤。,Clonaleosinophilia,Clonal,eosinophilia,might also,accompany,other World Health Organization-defined myeloid malignancies,including chronic myelogenous leukemia,myelodysplastic syndromes,chronic myelomonocytic leukemia,and systemic mastocytosis.,克隆性嗜酸性粒細(xì)胞增多癥,克隆性,嗜酸性粒細(xì)胞增多癥也可能,伴發(fā),其他世界衛(wèi)生組織定義的髓系惡性腫瘤,包括慢性粒細(xì)胞性白血病、骨髓增生異常綜合征,慢性髓單核細(xì)胞白血病、系統(tǒng)性肥大細(xì)胞增多癥。,Hypereosinophilicsyndrome,(HES),Hypereosinophilicsyndrome,(HES),a subcategory of idiopathic eosinophilia,is defined by the presence of a peripheral blood eosinophil count of,1.5 x 10(9)/L,or greater for at least,6 months,(a shorter duration is acceptable in the presence of symptoms that require eosinophil-lowering therapy),exclusion,of both secondary andclonaleosinophilia,evidence of organ involvement,and absence of phenotypically abnormal and/orclonalT lymphocytes.,高嗜酸性粒細(xì)胞綜合征,高嗜酸性粒細(xì)胞綜合征，即,特發(fā)性,嗜酸性粒細(xì)胞增多癥的一個(gè)亞類(lèi),被定義為存在外周血嗜酸性粒細(xì)胞計(jì)數(shù),1.5 x 10(9)/L,或更高至少,6個(gè)月,(當(dāng)出現(xiàn)需要給予降低嗜酸性粒細(xì)胞治療的癥狀時(shí)，更短時(shí)間內(nèi)是可以接受的)，同時(shí)需要,排除,繼發(fā)性和克隆性嗜酸性粒細(xì)胞增多，克隆性嗜酸性粒細(xì)胞增多的證據(jù)包括器官受累,沒(méi)有表型上的異常和/或克隆T淋巴細(xì)胞增多癥。,L,ymphocytic variant hyper eosinophilia,The presence of the latter defines,lymphocytic variant hyper eosinophilia,which is best classified under secondary eosinophilia.,In the current review,we provide a,simplified algorithm,for distinguishing the various causes ofclonaland idiopathic eosinophilia and discuss current therapy,including new drugs(imatinib mesylate,alemtuzumab,and mepolizumab).,淋巴細(xì)胞變異型高嗜酸性粒細(xì)胞增多癥,后者的存在定義為,淋巴細(xì)胞變異型,高嗜酸性粒細(xì)胞增多癥,最好將其歸類(lèi)為繼發(fā)性嗜酸性粒細(xì)胞增多癥。,在當(dāng)前的這篇評(píng)論性文章中,我們提供了一個(gè),簡(jiǎn)化的算法,區(qū)別各種原因引起的克隆性和特發(fā)性嗜酸性粒細(xì)胞增多并討論當(dāng)前的治療方法,包括新藥(甲磺酸伊馬替尼,CD52單抗-阿侖單抗和IL-5單抗-美泊利單抗)。,FIGURE.Diagnostic algorithm for clonal or idiopathic eosinophilia.CEL-NOS=chronic eosinophilic leukemia,not otherwise,specified;FISH=fluorescence in situ hybridization;HES=hypereosinophilic syndrome;PDGFR=platelet-derived growth factor,receptor;RT-PCR=reverse transcription polymerase chain reaction;TCR=T-cell receptor;WHO=World Health Organization.,Tefferi A.Blood eosinophilia:a new paradigm in disease classification,diagnosis,and treatment.Mayo Clin Proc.2005;80(1):75-83.,Tefferi A.Modern diagnosis andtreatmentof primary eosinophilia.Acta Haematol.2005;114(1):52-60.,Tefferi A,Patnaik MM,Pardanani A.Eosinophilia:secondary,clonal and idiopathic.Br J Haematol.2006;133(5):468-92.,Pardanani A,Tefferi A.Primary eosinophilic disorders:a concise review.Curr Hematol Malig Rep.2008;3(1):37-43.,Tefferi A,Vardiman JW.Classification and diagnosis of myeloproliferative neoplasms:the 2008 World Health Organization criteria and point-of-care diagnostic algorithms.Leukemia.2008;22(1):14-22.,Tefferi A,Gotlib J,Pardanani A.Hypereosinophilic syndrome and clonal eosinophilia:point-of-care diagnostic algorithm and treatment update.Mayo Clin Proc.2010;85(2):158-64.,Corresponding author,Ayalew Tefferi,MD,Divisions of Hematology and Internal Medicine,Mayo Clinic,200 First Street SW,Rochester,Minn.,USA,Thank you!,