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Leukemia - Acute

ALL with eosinophilia

Reviewer: Daniela Mihova, M.D. (see Reviewers page)
Revised: 1 February 2013, last major update September 2012
Copyright: (c) 2001-2013, PathologyOutlines.com, Inc.


● Not part of WHO classification
● ALL with marked eosinophilia is rare (< 50 cases reported through 2005), but may obscure ALL diagnosis
● Symptoms are related to hypereosinophilia, including respiratory failure, myocardial infarction and cerebrovascular accident (Leuk Lymphoma 2005;46:1045)
● Eosinophilia resolves with remission, returns with relapse
● Eosinophilia is usually reactive, not part of leukemic cells

Case reports

● 5 year old girl with 5q- deletion (Pediatr Dev Pathol 2003;6:558)
● 8 year old boy with t(5;9) and detection of residual disease in CSF by PCR (Arch Pathol Lab Med 2003;127:601)
● 10 year old girl with urticaria and hypereosinophilia (J Am Acad Dermatol 2004;51(5 Suppl):S151)
● 44 year old man with prior eosinophilic myelodysplasia (J Clin Pathol 1999;52:388)
● Young boy with T-ALL with eosinophilia and AML (Cytometry B Clin Cytom 2005;65:37)
● Prior idiopathic hypereosinophilic syndrome (Leuk Res 2005;29:975)


● Steroids suppress eosinophlia

Micro images

Bone marrow smear shows blasts, eosinophilic myelocytes, granulocytes and normoblasts

CSF shows prominent eosinophilia, basophilia and rare blasts (center)

Molecular description

● May have t(5;14)(q31;q32) - IL3 and IgH (Atlas of Genetics and Cytogenetics)

End of Leukemia - Acute > ALL with eosinophilia

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