LEUCEMIA EOSINOFÍLICA CRÔNICA: UMA REVISÃO CRÍTICA SOBRE OS AVANÇOS, DESAFIOS DIAGNÓSTICOS E PERSPECTIVAS TERAPÊUTICAS
Resumo
A Leucemia Eosinofílica Crônica (LEC) é uma neoplasia mieloproliferativa BCR::ABL1-negativa, caracterizada pela proliferação clonal e persistente de eosinófilos associada a alterações moleculares específicas. Trata-se de uma doença rara e de baixa incidência, cujo diagnóstico permanece desafiador devido à semelhança com outras causas de hipereosinofilia, o que pode comprometer a intervenção terapêutica e favorecer o surgimento de complicações. O presente estudo teve como objetivo analisar criticamente a literatura científica acerca da LEC, com ênfase nos avanços moleculares, nos desafios diagnósticos e nas perspectivas terapêuticas. Trata-se de uma pesquisa de abordagem qualitativa, de caráter descritivo, desenvolvida por meio de revisão crítica da literatura, com levantamento de dados nas bases PubMed, SciELO, LILACS, Periódicos CAPES e Google Acadêmico, abrangendo o período de 2020 à março de 2026. Os resultados evidenciaram que a LEC apresenta manifestações clínicas variadas e inespecíficas, associadas a achados laboratoriais relevantes e alterações genéticas, destacando-se a fusão FIP1L1::PDGFRA, responsável pela ativação constitutiva da tirosina-quinase e pela proliferação desregulada de eosinófilos. Observou-se ainda que o diagnóstico requer abordagem integrada entre dados clínicos, laboratoriais e moleculares. Conclui-se que, apesar dos avanços observados, a LEC ainda apresenta desafios relacionados ao diagnóstico precoce, sendo fundamental ampliar o conhecimento científico sobre a doença para aprimorar o manejo clínico e o prognóstico dos pacientes.
Biografia do Autor
Graduanda em biomedicina.
Graduanda em biomedicina.
Graduanda em biomedicina.
Biomédico, mestre em Hematologia- UEA/FUNDAÇÃO HEMOAM.
Biomédico, mestre em Biotecnologia- FAMETRO.
Referências
ABU ZAHRA, Ahmad et al. FIP1L1 PDGFRA Positive Chronic Eosinophilic Leukemia Presenting With Vestibular Neuritis. Clinical Case Reports, v. 13, n. 6, p. e70554, jun. 2025.
ARBER, Daniel A. et al. International Consensus Classification of Myeloid Neoplasms and Acute Leukemias: integrating morphologic, clinical, and genomic data. Blood, v. 140, n. 11, p. 1200–1228, 15 set. 2022.
BALANCHIVADZE, Nino et al. A Case of Chronic Eosinophilic Leukemia in a Patient With Recurrent Cough, Dyspnea, and Eosinophilia. Cureus, 12 jan. 2021.
BOI-DOKU PEPRA-AMEYAW, Nii et al. Chronic Eosinophilic Leukemia Presenting as Cardiac Failure. Case Reports in Hematology, v. 2022, p. 1–5, 16 dez. 2022.
BOTHALE, Kalpana; SALKAR, Akanksha; SALKAR, Amit. A rare case of PDGFRA-positive chronic eosinophilic leukemia. Indian Journal of Pathology and Microbiology, 17 out. 2024.
CHOUDHURI, Jui et al. Intermediate between Idiopathic Hypereosinophilia and Chronic Eosinophilic Leukemia: A Report of Two Hypereosinophilic Cases with Possible Novel Molecular Mutations. Case Reports in Hematology, v. 2021, p. 1–6, 31 ago. 2021.
CRUZ-ACEVEDO, Ana Karen et al. A Critical Case of Chronic Eosinophilic Leukemia: Diagnostic Criteria and Response to Cytarabine. Case Reports in Oncological Medicine, v. 2025, n. 1, p. 8887007, jan. 2025.
DIOGO, Icr et al. LEUCEMIA EOSINOFÍLICA CRÔNICA COM ACOMETIMENTO ÓSSEO: UM RELATO DE CASO. Hematology, Transfusion and Cell Therapy, v. 45, p. S209–S210, out. 2023.
DUFFIELD, Amy S. et al. Myeloid Neoplasm with PDGFRA Rearrangement Manifesting as a Retromolar Pad Mass. Head and Neck Pathology, v. 15, n. 4, p. 1399–1403, dez. 2021.
EBRAHIMI, Nasim et al. Receptor tyrosine kinase inhibitors in cancer., v. 80, n. 4, p. 104, 22 mar. 2023.
FARAJ, Raid et al. Loeffler endocarditis revealing chronic eosinophilic leukaemia with FIP1L1-PDGFRA rearrangement: a case report. European Heart Journal - Case Reports, v. 9, n. 5, p. ytaf218, 2 maio 2025.
GOASGUEN, Jean E. et al. The role of eosinophil morphology in distinguishing between reactive eosinophilia and eosinophilia as a feature of a myeloid neoplasm. British Journal of Haematology, v. 191, n. 3, p. 497–504, nov. 2020.
HAYDON, Steven J. et al. Chronic Eosinophilic Leukemia Positive for FIP1L1PDGFRa. Cureus, 24 fev. 2025.
IBERTI, Mathilde et al. Novel ETV6::RAPGEF6 fusion gene in chronic eosinophilic leukemia: compiling evidence on the role of IL3 overexpression in tumorigenesis. Annals of Hematology, v. 104, n. 3, p. 2017–2021, mar. 2025.
IURLO, A.; CATTANEO, D. Biological therapies for hypereosinophilic disorders: from tyrosine kinase inhibitors to monoclonal antibodies. Towards a more personalized approach? Blood Reviews, v. 58, p. 101014, 2023.
JABBOUR, E. et al. Ponatinib vs Imatinib in Frontline Philadelphia ChromosomePositive Acute Lymphoblastic Leukemia. JAMA, v. 331, n. 21, p. 1814–1814, 4 jun. 2024.
JESUS, Av et al. HIPEREOSINOFILIA SECUNDÁRIA À SARCOMA DE PARTES MOLES MIMETIZANDO LEUCEMIA EOSINOFÍLICA CRÔNICA: RELATO DE CASO. Hematology, Transfusion and Cell Therapy, v. 47, p. 104283, out. 2025.
KAUR, Prabhjot; KHAN, Wahab A. Myeloid/Lymphoid Neoplasms with Eosinophilia and Platelet Derived Growth Factor Receptor Alpha (PDGFRA) Rearrangement. In: DEPARTMENT OF PATHOLOGY AND LABORATORY MEDICINE, CHILDREN’S MERCY HOSPITAL, UNIVERSITY OF MISSOURI-KANSAS CITY SCHOOL OF MEDICINE, KANSAS CITY, USA; WEIJIE, Li (Orgs.). Leukemia. [S.l.]: Exon Publications, 2022. P. 129–146.
KAWASHIMA, Ichiro; KIRITO, Keita. [Chronic neutrophilic leukemia/chronic eosinophilic leukemia]. [Rinsho Ketsueki] The Japanese Journal of Clinical Hematology, v. 64, n. 10, p. 1326–1334, 2023.
KRAH, Nathan M. et al. JAK2 R683S Mutation Resulting in Dual Diagnoses of Chronic Eosinophilic Leukemia and Myelodysplastic/Myeloproliferative Overlap Syndrome. Journal of the National Comprehensive Cancer Network, v. 21, n. 12, p. 1218–1223, dez. 2023.
KHOURY, Joseph D. et al. The 5th edition of the World Health Organization Classification of Haematolymphoid Tumours: Myeloid and Histiocytic/Dendritic Neoplasms. Leukemia, v. 36, n. 7, p. 1703–1719, jul. 2022.
KLION Ad. Approach to the patient with suspected hypereosinophilic syndrome. Hematology Am Soc Hematol Educ Program. 2022 Dec 9;2022(1):47-54.
LEACH, Mike. The diagnostic utility of eosinophil morphology. British Journal of Haematology, v. 191, n. 3, p. 325–325, nov. 2020.
METZGEROTH, G. et al. Treatment-free remission in FIP1L1-PDGFRA-positive myeloid/lymphoid neoplasms with eosinophilia after imatinib discontinuation. Blood Advances, v. 4, n. 3, p. 440–448, 2020.
MORALES-CAMACHO, Rosario M. et al. Hematological Neoplasms with Eosinophilia. Cancers, v. 16, n. 2, p. 337, 12 jan. 2024.
MORSIA, Erika et al. WHO defined chronic eosinophilic leukemia, not otherwise specified (CEL, NOS): A contemporary series from the Mayo Clinic. American Journal of Hematology, v. 95, n. 7, jul. 2020.
NASCIMENTO, Mod et al. CARACTERIZAÇÃO CLÍNICA E LABORATORIAL DE PACIENTES COM NEOPLASIAS MIELOPROLIFERATIVAS BCR::ABL1 NEGATIVAS EM UMA COORTE DO AMAZONAS. Hematology, Transfusion and Cell Therapy, v. 47, p. 104407, out. 2025.
NAGASE, Hiroyuki; UEKI, Shigeharu; FUJIEDA, Shigeharu. The roles of IL-5 and anti-IL-5 treatment in eosinophilic diseases: Asthma, eosinophilic granulomatosis with polyangiitis, and eosinophilic chronic rhinosinusitis. Allergology International, v. 69, n. 2, p. 178–186, abr. 2020.
Nguyen L, Zhang L. Chronic eosinophilic leukemia. PathologyOutlines.com Websit e. https://www.pathologyoutlines.com/topic/myeloproliferativecel.html Acessado em: 20 de março de 2026.
REQUENA, G. et al. Clinical profile and treatment in hypereosinophilic syndrome variants: a pragmatic review. The Journal of Allergy and Clinical Immunology: In Practice, v. 10, n. 8, p. 2125–2134, 2022. ROSSI, Vanessa et al. Laboratory Aspects and Diagnostic Challenges in a Case of Hypereosinophilic Syndrome. Cureus, 16 jan. 2026.
SANTOS, Lpd et al. PREVALÊNCIA DE PRESENÇA DE MUTAÇÃO DO GENE V617F JAK2 EM PACIENTES COM NEOPLASIAS MIELOPROLIFERATIVAS PHILADELPHIA NEGATIVO ATENDIDOS EM UM CENTRO DE REFERÊNCIA NO SUL DO BRASIL. Hematology, Transfusion and Cell Therapy, v. 46, p. S499S500, out. 2024.
ŞANLI, Neslihan Mandacı; TIMUROĞLU, Aysu. Perspective Chapter: Overview of Eosinophilia in Hematologic Cancers. [S.l.]: IntechOpen, 2025.
SEVERINO, Victor Vilela Carvalho et al. Avanços Terapêuticos de Última Geração para Cânceres Hematológicos: Leucemia, Linfoma e Mieloma. Brazilian Journal of Implantology and Health Sciences, v. 5, n. 5, p. 99–111, 2 out. 2023.
SHOMALI, William et al. A novel activating JAK1 mutation in chronic eosinophilic leukemia. Blood Advances, v. 5, n. 18, p. 3581–3586, 28 set. 2021.
SHOMALI, William; GOTLIB, Jason. World Health Organization‐defined eosinophilic disorders: 2022 update on diagnosis, risk stratification, and management. American Journal of Hematology, v. 97, n. 1, p. 129–148, jan. 2022.
SHOMALI, William; GOTLIB, Jason. World Health Organization and International Consensus Classification of eosinophilic disorders: 2024 update on diagnosis, risk stratification, and management. American Journal of Hematology, v. 99, n. 5, p. 946–968, maio 2024.
SZYMCZYK, Agnieszka; JAWORSKI, Jakub; PODHORECKA, Monika. The challenge of diagnosing and classifying eosinophilia and eosinophil disorders: A review. Central European Journal of Immunology, v. 49, n. 1, p. 60–69, 19 abr. 2024.
SOUSA, G. F. et al. DESAFIOS TERAPÊUTICOS DA LEUCEMIA EOSINOFÍLICA AGUDA: UM RELATO DE CASO. Hematology, Transfusion and Cell Therapy, v. 47, p. 104525, 2025.
TAKLA A, Shah P, Sbenghe M, Baibhav B, Feitell S. Incessant Ventricular Tachycardia: An Atypical Presentation of Chronic Eosinophilic Leukemia. JACC Case Rep. 2024 Aug 21;29(16):102461. VALENT, Peter et al. Proposed refined diagnostic criteria and classification of eosinophil disorders and related syndromes. Allergy, v. 78, n. 1, p. 4759, jan. 2023.
VALENT, Peter et al. Eosinophils and eosinophil-associated disorders: immunological, clinical, and molecular complexity. Seminars in Immunopathology, v. 43, n. 3, p. 423–438, jun. 2021.
WANG, Jinlin; LIN, Meitong; WANG, Fan. Epidemiology and prognostic nomogram for chronic eosinophilic leukemia: a population-based study using the SEER database. Scientific Reports, v. 14, n. 1, p. 4594, 26 fev. 2024.
WANG, Sa A. et al. The international consensus classification of eosinophilic disorders and systemic mastocytosis. American Journal of Hematology, v. 98, n. 8, p. 1286–1306, ago. 2023.
WAHED, Amer; QUESADA, Andres; DASGUPTA, Amitava. Hematology and coagulation: a comprehensive review for board preparation, certification and clinical practice. Second edition ed. Amsterdam, Netherlands: Academic Press, an imprint of Elsevier, 2020.
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