期刊
JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY
卷 124, 期 6, 页码 1319-1325出版社
MOSBY-ELSEVIER
DOI: 10.1016/j.jaci.2009.09.022
关键词
Eosinophil; hypereosinophilic syndrome; FIP1L1-PDGFRA
资金
- Division of Intramural Research of the NIAID/NIH
- NIH [AI41472, AI72265, AI061097]
- Dana Foundation
- Swiss National Science Foundation
- Belgian National Fund for Scientific Research
- Campaign Urging Research for Eosinophilic Disorders
Background: Hypereosinophilic syndrome (HES) is a heterogeneous group of rare disorders defined by persistent blood eosinophilia >= 1.5 X 10(9)/L, absence of a secondary cause, and evidence of eosinophil-associated pathology. With the exception of a recent multicenter trial of mepolizumab (anti-IL-5 mAb), published therapeutic experience has been restricted to case reports and small case series. Objective: The purpose of the study was to collect and summarize baseline demographic, clinical, and laboratory characteristics in a large, diverse cohort of patients with HES and to review responses to treatment with conventional and novel therapies. Methods: Clinical and laboratory data from 188 patients with HES, seen between January 2001 and December 2006 at 11 institutions in the United States and Europe, were collected retrospectively by chart review. Results: Eighteen of 16.1. patients (11%) tested were Fip1-like I-platelet-derived growth factor receptor alpha (FIP1L1-PDGFRA) mutation-positive, and 29 of 168 patients tested (17%) had a demonstrable aberrant or clonal T-cell population. Corticosteroid monotherapy induced complete or partial responses at I month in 85% (120/141) of patients with most remaining on maintenance doses (median, 10 mg prednisone equivalent daily for 2 months to 20 years). Hydroxyurea and IFN-alpha (used in 64 and 46 patients, respectively) were also effective, but their use was limited by toxicity. Imatinib (used in 68 patients) was more effective in patients with the FIP1L1-PDGFRA mutation (88%) than in those without (23%; P < .001). Conclusion: This study, the largest clinical analysis of patient's with HES to date, not only provides useful information for clinicians but also should stimulate prospective trials to optimize treatment of HES. (J Allergy Clin Immunol 2009;124:1319-25.)
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