Tryptase 농도 상승을 동반한 골수증식성 과호산구증가증에서 발생된 만성 호산구성 백혈병

A 72-year-old male patient was referred to the hematologic department because of persistent hypereosinophilia, splenomegaly and chronic fatigue; these existed for 3 months. A presumptive diagnosis of a myeloproliferative variant of hypereosinophilic syndrome was made on the basis of anemia, splenomegaly, bone marrow hypercelluarity, increased serum tryptase and vitamine B12. Fip 1 like 1-platelet-driven growth factor receptor alpha fusion gene and platelet-driven growth factor receptor beta gene rearrangement analysis with RT PCR were negative. In initial therapeutic approach with prednisolone, hydroxyurea, and imatinib mesyalte, blood eosniophilia did not improve and transformation into chronic eosinophilic leukemia observed in the peripheral blood smear. In the case herein reported, therapeutic response was not achieved with cytosine arabinoside chemotherapy. (Korean J Asthma Allergy Clin Immunol 2007;27:61-65)