Chronic eosinophilic leukemia presenting with autoimmune hemolytic anemia and erythrophagocytosis by eosinophils

• Published in: American journal of hematology Vol. 81; no. 6; pp. 458 - 461
• Main Authors: Kuk, J.S., MacEachern, J.A., Soamboonsrup, P., McFarlane, A., Benger, A., Patterson, W., Yang, L., Trus, M.R.
• Format: Journal Article
• Language: English
• Published: Hoboken Wiley Subscription Services, Inc., A Wiley Company 01.06.2006; Wiley-Liss
• Subjects: Aged; anemia; Anemia, Hemolytic, Autoimmune - blood; Anemia, Hemolytic, Autoimmune - complications; Anemia, Hemolytic, Autoimmune - pathology; Anemias. Hemoglobinopathies; Biological and medical sciences; Bone Marrow - pathology; Diseases of red blood cells; Eosinophils - pathology; Erythrocytes - pathology; erythrophagocytosis; Glycoproteins - metabolism; Hematologic and hematopoietic diseases; hemolytic; Humans; hypereosinophilia; Hypereosinophilic Syndrome - blood; Hypereosinophilic Syndrome - complications; Hypereosinophilic Syndrome - pathology; leukemia; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis; Leukocyte Count; Lymphoma, Non-Hodgkin - blood; Lymphoma, Non-Hodgkin - pathology; Lysophospholipase - metabolism; Male; Medical sciences; Myelopoiesis; Neoplasms, Second Primary - blood; Neoplasms, Second Primary - complications; Neoplasms, Second Primary - pathology; Phagocytosis; Autoimmunity; Immunopathology; leukemia; Eosinophilic leukemia; Hematology; Granulocyte; Malignant hemopathy; Eosinophil; Erythrophagocytosis; anemia; Myeloproliferative syndrome; Chronic; Hemolytic anemia; Autoimmune hemolytic anemia; hypereosinophilia; hemolytic
• ISSN: 0361-8609; 1096-8652
• DOI: 10.1002/ajh.20601

Eosinophils function primarily as secretory cells and phagocytosis by eosinophils is rarely seen. We describe a case of chronic eosinophilic leukemia (CEL) in a 72‐year‐old male with a history of previously treated non‐Hodgkin's lymphoma (NHL) presenting with erythrophagocytosis by eosinophils and an associated autoimmune hemolytic anemia (AIHA). This patient did not show evidence of relapsed NHL. The patient's blood showed a markedly elevated eosinophil count of 16 × 109/L [normal 0–0.45 × 109/L] on a background of myelodysplasia and features of AIHA. Prominent erythrophagocytosis by eosinophils was visualized in the blood and in the bone marrow. Numerous Charcot–Leyden crystals were also seen in the bone marrow amid increased numbers of eosinophils and the presence of dysplastic granulopoiesis. AIHA is rarely described in the setting of CEL. More significantly, this represents the first case report to describe erythrophagocytosis by eosinophils. Am. J. Hematol. 81:458–461, 2006. © 2006 Wiley‐Liss, Inc.