CHRONIC MYELOID-LEUKEMIA ASSOCIATED HYPEREOSINOPHILIC SYNDROME WITH ACLONAL T(4-7)(Q11-Q32)

Patients with chronic myeloid leukemia (CML) show the Philadelphia (Ph ) translocation in more than 95% of the cases. The remaining cases, wi thout the cytogenetic or molecular equivalent of the BCR-ABL rearrange ment, are ''Philadelphia negative'' and may have alternate chromosomal aberrations. Ph negative CML patients are known to have a poor progno sis. We report on a young patient with a hypereosinophilic syndrome in the presence of a clonal translocation t(4;7) with a peripheral leuko cytosis, a severe thrombocytopenia, and anemia at first presentation, who developed bone marrow changes typical of CML. bone marrow function and hypereosinophilia improved only partially and temporarily under t herapy. The patient died 10 months after diagnosis of diffuse leukemic embolism and organ infiltration resulting in paraplegia. The case dem onstrates that beside ''idiopathic'' hypereosinophilic syndromes (HES) , a proportion of such patients suffer from eosinophilic leukemias. In these cases, karyotype analysis may help to distinguish these states by the identification of clonal chromosomal abnormalities. A karyotype anomaly hitherto not reported can be added to the list of aberrations in hypereosinophilic states associated with myeloproliferative proces ses. (C) Elsevier Science Inc., 1997.