Chronic eosinophilic leukemia with FIP1L1-PDGFRA transcripts after occupational and therapeutic exposure to radiation

Abstract

We present for the first time a 40-year-old male patient with a 20 year history of occupational exposure to radiation as a nuclear power plant worker, who developed FIP1L1-PDGFRA-positive chronic eosinophilic leukemia 27 months after radiotherapy for testicular seminoma. After an one-year history of dry cough, itching and night sweats, the patient presented with an elevated leukocyte count with absolute eosinophilia of 14.2x109 /L, bone marrow and lymph node involvement. Treatment with Imatinib was ini-tiated, resulting in complete hematological remission at the sixth month and complete molecular response by nested primers reverse transcription polymerase chain reaction – at the end of the first year. This case contributes to the clinical heterogeneity of a rare entity such as FIP1L1-PDGFA-positive myeloprolifer-ative neoplasms, and for the possible role of occupational and therapeutic radiation, rais-ing the question if one or both of them might be the causative factor.