Acute lymphocytic leukemia with eosinophilia: two case reports and a literature review

Acute lymphocytic leukemia (ALL) associated with eosinophilia is a rare occurrence, but a distinct clinicopathological entity. There have been approximately 44 cases reported in the world literature to date. We report 2 previously healthy young men, aged 20 and 32 years, who presented with marked eosinophilia, and were later diagnosed with pre-B ALL. The patients suffered from significant complications related to eosinophil toxicity, including respiratory failure, myocardial infarction, and a cerebrovascular accident during initial hospitalization. They were treated with high-dose steroids resulting in a rapid suppression of the eosinophilia. Both patients also received chemotherapy according to the standard protocol for ALL; unfortunately, case 1 expired within 2 years of diagnosis from complications related to sepsis and multi-organ failure. We also review the literature and compare the demographics, clinical features, and outcomes of several case studies reported.