Successful Treatment For Chronic Eosinophilic Leukemia (CEL) With Imatinib Mesylate

  • Rayane da Silva Souza
  • Nathalia de Alencar Cunha Tavares
  • Martina Bragante Fernandes Pimenta
  • Marcelle Bragante Fernandes Pimenta
  • Matheus Cartaxo Eloy Fialho
  • Ary Serrano Santos
  • Alexandre Rolim da Paz
  • Flávia Cristina Fernandes Pimenta Federal University of Paraíba

Abstract

We report a case of a patient with Chronic Eosinophilic Leukemia (CEL) with mutation in alfa PDGFR gene exhibiting a satisfactory response to treatment with imatinib mesylate. A 25-year-old man presented in a hematology service with a persistent cough and hemogram alterations. His blood count showed a hemoglobin level of 12.5 g/dL and a white blood cell count of 94,030/mm3, eosinophils were 68% of all cells. Bone marrow aspiration and biopsy showed hypercellularity with marked eosinophilia (77%) and erythroid differentiation series was hypocellular with normoblast maturation. The immunohistochemically of the bone biopsy was positive for myeloperoxidase and negative for CD34/CD99, consistent with CEL. Fluorescence in situ hybridization (FISH) for the beta-fraction of platelet-derived growth factor (PDGFRβ) and Philadelphia chromosome (Ph 1) were negative and the alfa PDGFR (Platelet-Derived Growth Factor) was positive and showed heterozygosis in c.2531T>C on 18 Exon and homozygous in C.2562+1G>A at the region of the splicing site at the 18 intron. Treatment was initiated and maintained by administering 400mg/day imatinib mesylate. Laboratory findings returned to normal ranges, with clinical improvement and a hematological response observed after the second month of therapy. Currently, the patient’s blood count shows the white blood cell count (5,400 total leukocytes), eosinophils (8.6/mm3), hemoglobin (15.5 g/dl), hematocrit (45.4%) and platelets (298,000/mm3) within normal ranges. The mutation search was negative in in peripheral blood one year after the initial treatment. Our work corroborates other studies on the efficacy of imatinib mesylate in the treatment of patients with CSF PDGFR alpha positive. We emphasize the importance of molecular studies, considering its relevance for the correct staging of the disease. Since CEL is a rare disease, it is important to define its etiology and anticipate its treatment, thus minimizing the damage induced by the disease.

Author Biographies

Rayane da Silva Souza

Department of Medicine, Federal University of Paraíba, João Pessoa, Paraíba, Brazil.

Nathalia de Alencar Cunha Tavares

Lauro Wanderley University Hospital - Federal University of Paraíba, João Pessoa, Paraíba, Brazil.

Martina Bragante Fernandes Pimenta

Department of Medicine, Federal University of Paraíba, João Pessoa, Paraíba, Brazil

Marcelle Bragante Fernandes Pimenta

Department of Medicine, Nova Esperança College, João Pessoa, Paraíba, Brazil

Matheus Cartaxo Eloy Fialho

Department of Medicine, Federal University of Paraíba, João Pessoa, Paraíba, Brazil.

Ary Serrano Santos

Lauro Wanderley University Hospital - Federal University of Paraíba, João Pessoa, Paraíba, Brazil

Alexandre Rolim da Paz

Department of Medicine, Federal University of Paraíba, João Pessoa, Paraíba, Brazil.

Lauro Wanderley University Hospital - Federal University of Paraíba, João Pessoa, Paraíba, Brazil

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Published
2017-12-31
How to Cite
SOUZA, Rayane da Silva et al. Successful Treatment For Chronic Eosinophilic Leukemia (CEL) With Imatinib Mesylate. International Archives of Medicine, [S.l.], v. 10, dec. 2017. ISSN 1755-7682. Available at: <http://imedicalsociety.org/ojs/index.php/iam/article/view/2602>. Date accessed: 20 aug. 2018. doi: https://doi.org/10.3823/2539.
Section
Hematology