The clinical, laboratory, and autopsy findings of eosinophilic leukemia in five cases seen by the authors and in 43 patients reported in the literature were reviewed. Heart failure, respiratory distress, central nervous system manifestations, and fever were characteristic symptoms. Hepatosplenomegaly was found in 31 patients and lymphadenopathy in 26 patients. Marked eosinophilia occurred in 48, leukocytosis in 37, blast forms in 27, shift to the left in 25, and normoblasts in 11 of the 48 cases. Bone marrow biopsy revealed fibrosis in three patients. Therapy failed in all instances, and 39 patients died within 12 months. At postmortem examination the liver, spleen, lymph nodes, bone marrow, heart, lung, central nervous system, skin, and other organs were infiltrated with eosinophilic granulocytes. Chloroma or myeloblastoma was found in six patients. Mural thrombi were present in 15, eosinophilic infiltration of myocardium in 18, and thromboses of small vessels of the heart, lung, or brain in 10 cases.
Eosinophilic leukemia can manifest features of the myeloproliferative as well as the hyperallergic disorders.