title: How I treat hypereosinophilic syndromes.
abstract: Hypereosinophilic syndromes (HESs) are a heterogeneous group of uncommon disorders characterized by marked peripheral eosinophilia and end organ manifestations attributable to the eosinophilia or unexplained in the clinical setting. Whereas corticosteroids remain the mainstay of treatment for most patients, recent diagnostic advances and the development of novel targeted therapies, including tyrosine kinase inhibitors and humanized monoclonal antibodies, have increased the complexity of therapeutic decisions in HESs. This review presents a treatment-based approach to the diagnosis and classification of patients with peripheral blood eosinophilia of 1.5 x 10(9)/L (1500/mm3) or higher and discusses the role of currently available therapeutic agents in the treatment of these patients.
authors.affiliation: Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA. aklion@niaid.nih.gov
authors.forename: Amy D
authors.initials: AD
authors.lastname: Klion
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D006801:Humans; D017681:Hypereosinophilic Syndrome / Q000097:blood* / Q000145:classification / Q000175:diagnosis* / Q000188:drug therapy*; D047428:Protein Kinase Inhibitors / Q000627:therapeutic use*
chemical_list: D000305:Adrenal Cortex Hormones; D000911:Antibodies, Monoclonal; D047428:Protein Kinase Inhibitors
references.citation: N Engl J Med. 2003 Mar 27;348(13):1201-14
references.pmid: 12660384
references.citation: Bone Marrow Transplant. 2006 Aug;38(4):319-20
references.pmid: 16819435
references.citation: N Engl J Med. 1999 Oct 7;341(15):1112-20
references.pmid: 10511609
references.citation: J Infect Dis. 1986 Jul;154(1):10-8
references.pmid: 3458832
references.citation: N Engl J Med. 2003 Dec 11;349(24):2334-9
references.pmid: 14668459
references.citation: Acta Haematol. 2005;114(1):26-40
references.pmid: 15995323
references.citation: Leukemia. 2009 Feb;23(2):332-9
references.pmid: 18987650
references.citation: Blood. 2003 Jun 15;101(12):4660-6
references.pmid: 12676775
references.citation: Blood. 2000 Dec 15;96(13):4285-92
references.pmid: 11110703
references.citation: Blood. 2007 Nov 15;110(10):3552-6
references.pmid: 17709602
references.citation: Eur J Haematol. 2008 Jan;80(1):81-6
references.pmid: 18028420
references.citation: Blood. 2004 Jun 1;103(11):4050-5
references.pmid: 14988154
references.citation: N Engl J Med. 2008 Mar 20;358(12):1215-28
references.pmid: 18344568
references.citation: Br J Haematol. 2008 Apr;141(2):200-4
references.pmid: 18307562
references.citation: Haematologica. 2005 Jun;90(6):753-65
references.pmid: 15951288
references.citation: Medicine (Baltimore). 1975 Jan;54(1):1-27
references.pmid: 1090795
references.citation: Leuk Res. 2009 Nov;33(11):1481-4
references.pmid: 19193436
references.citation: Leuk Res. 2009 Aug;33(8):1127-9
references.pmid: 19144405
references.citation: Blood. 2003 Nov 1;102(9):3456-7; author reply 3457
references.pmid: 14568908
references.citation: J Allergy Clin Immunol. 2007 Sep;120(3):680-7
references.pmid: 17628645
references.citation: Lancet. 2003 Aug 16;362(9383):535-6
references.pmid: 12932387
references.citation: Blood. 2004 Jan 15;103(2):473-8
references.pmid: 14504092
references.citation: Blood. 2003 May 1;101(9):3391-7
references.pmid: 12506022
references.citation: Br J Haematol. 2004 Dec;127(5):477
references.pmid: 15566349
references.citation: Leuk Res. 2009 Jun;33(6):837-9
references.pmid: 19013640
references.citation: Int Arch Allergy Immunol. 2001 Jan-Mar;124(1-3):242-5
references.pmid: 11306981
references.citation: J Allergy Clin Immunol. 2006 Jun;117(6):1292-302
references.pmid: 16750989
references.citation: Leuk Res. 2006 Dec;30(12):1499-505
references.pmid: 16682077
references.citation: Leuk Lymphoma. 2004 Dec;45(12):2503-7
references.pmid: 15621768
references.citation: Blood. 2009 Jul 30;114(5):937-51
references.pmid: 19357394
references.citation: Circulation. 1978 Apr;57(4):824-7
references.pmid: 204428
references.citation: J Allergy Clin Immunol. 2009 Dec;124(6):1319-25.e3
references.pmid: 19910029
references.citation: Ann Intern Med. 1994 Nov 1;121(9):648-53
references.pmid: 7944072
references.citation: Blood. 2006 Aug 15;108(4):1374-6
references.pmid: 16645167
references.citation: J Allergy Clin Immunol. 2008 Apr;121(4):1054-6
references.pmid: 18234315
references.citation: Br J Haematol. 2000 Jun;109(3):540-8
references.pmid: 10886202
references.citation: Leuk Lymphoma. 2004 Dec;45(12):2497-501
references.pmid: 15621767