From the Guidelines
The treatment approach for eosinophilia caused by lymphoma primarily focuses on treating the underlying lymphoma itself, with the most effective strategy involving systemic chemotherapy regimens such as CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone) for non-Hodgkin lymphoma.
Key Considerations
- The inclusion of corticosteroids like prednisone in these regimens helps reduce eosinophil counts rapidly 1.
- For patients with T-cell lymphomas specifically associated with eosinophilia, targeted therapies may be considered, including JAK inhibitors like ruxolitinib or tyrosine kinase inhibitors if specific genetic mutations are present.
- Supportive care to manage complications of eosinophilia, such as antihistamines for pruritus or cardiac monitoring for those with very high eosinophil counts, should be implemented alongside primary treatment 1.
Treatment Approach
- The current standard for CD20+ large-cell non-Hodgkin’s lymphoma of all stages is six to eight cycles of combination chemotherapy with CHOP treatment combined with eight doses of rituximab given every 21 or 14 days with growth factor support 1.
- The staging of the lymphoma is crucial, using the Ann Arbor system and considering the International Prognostic Index (IPI) for prognostic purposes 1.
Monitoring and Follow-Up
- Regular complete blood counts should be performed to track eosinophil levels throughout treatment, as eosinophil counts can serve as a potential marker for treatment response and disease monitoring.
- The eosinophilia typically resolves as the lymphoma responds to treatment, indicating the importance of monitoring and adjusting the treatment plan as necessary 1.
From the Research
Eosinophilia Caused by Lymphoma
- Eosinophilia is defined as an elevation of eosinophils in the bloodstream, with various causes including parasitic disease, allergic disease, autoimmune disease, and malignant states such as lymphoma 2.
- Lymphoma is a group of malignant neoplasms of lymphocytes, with more than 90 subtypes, and can cause eosinophilia as part of its clinical presentation 3.
Treatment Approach
- The treatment approach for eosinophilia caused by lymphoma depends on the underlying type and stage of lymphoma 3, 4.
- For non-Hodgkin lymphoma, treatment plans differ between subtypes, with CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) with or without rituximab (R-CHOP) being a common regimen 3, 5.
- For Hodgkin lymphoma, treatment options include combined chemotherapy with ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine), Stanford V, or BEACOPP, with radiotherapy also being considered 3, 6, 4.
- In cases where eosinophilia is present, treatment of the underlying lymphoma is crucial, and management of eosinophilia may involve monitoring and supportive care to prevent complications 2.
Management Considerations
- Patients with lymphoma, including those with eosinophilia, require routine surveillance to monitor for complications and relapse, as well as age-appropriate screenings 3.
- Vaccinations, such as the 13-valent pneumococcal conjugate vaccine and 23-valent pneumococcal polysaccharide vaccine, are recommended for patients with lymphoma to prevent infections 3.