Association of the blood eosinophil count with hematological malignancies and mortality

TY - JOUR

T1 - Association of the blood eosinophil count with hematological malignancies and mortality

AU - Andersen, Christen Bertel L

AU - Siersma, Volkert Dirk

AU - Hasselbalch, Hans K

AU - Vestergaard, Hanne

AU - Mesa, Ruben

AU - Felding, Peter

AU - Olivarius, Niels de Fine

AU - Bjerrum, Ole Weis

PY - 2015/3/1

Y1 - 2015/3/1

N2 - Blood eosinophilia (≥0.5 × 109/l) may be an early sign of hematological malignancy. We investigated associations between levels of blood eosinophils and risks of hematological malignancies and mortality in order to provide clinically derived cut-offs for referral to specialist hematology care. From the Copenhagen Primary Care Differential Count (CopDiff) Database, we identified 356,196 individuals with at least one differential cell count encompassing the eosinophil count during 2000–2007 and matched these laboratory data with Danish nationwide health registers. We used multivariable logistic regression to calculate odds ratios (ORs) for the 4-year incidences of hematological malignancies and mortality between the eosinophil counts and a reference count of 0.16 × 109/l which was the median eosinophil count in our data. Risks of hematological malignancies and mortality increased above the median eosinophil count. At the 99th percentile, corresponding to an eosinophil count of 0.75 × 109/l, risks of hematological malignancies were increased more than twofold with OR (95% C.I.) of 2.39 (1.91–2.99). Interestingly, risks reached a plateau around an eosinophil count of 1.0 × 109/l. Risks also increased when the eosinophil count approached zero. Here, counts associated relatively more with acute myeloid leukemia and myelodysplastic syndromes whereas counts above 0.16 × 109/l associated more with myeloproliferative neoplasms. Eosinophil counts associate with hematological malignancies and mortality even below the definition of eosinophilia. The observed plateau of risks around 1.0 × 109/l is important for physicians encountering patients with eosinophilia since even mild-to-moderate eosinophilia according to traditional definitions confers maximally increased risks of subsequent/subclinical hematological malignancy

AB - Blood eosinophilia (≥0.5 × 109/l) may be an early sign of hematological malignancy. We investigated associations between levels of blood eosinophils and risks of hematological malignancies and mortality in order to provide clinically derived cut-offs for referral to specialist hematology care. From the Copenhagen Primary Care Differential Count (CopDiff) Database, we identified 356,196 individuals with at least one differential cell count encompassing the eosinophil count during 2000–2007 and matched these laboratory data with Danish nationwide health registers. We used multivariable logistic regression to calculate odds ratios (ORs) for the 4-year incidences of hematological malignancies and mortality between the eosinophil counts and a reference count of 0.16 × 109/l which was the median eosinophil count in our data. Risks of hematological malignancies and mortality increased above the median eosinophil count. At the 99th percentile, corresponding to an eosinophil count of 0.75 × 109/l, risks of hematological malignancies were increased more than twofold with OR (95% C.I.) of 2.39 (1.91–2.99). Interestingly, risks reached a plateau around an eosinophil count of 1.0 × 109/l. Risks also increased when the eosinophil count approached zero. Here, counts associated relatively more with acute myeloid leukemia and myelodysplastic syndromes whereas counts above 0.16 × 109/l associated more with myeloproliferative neoplasms. Eosinophil counts associate with hematological malignancies and mortality even below the definition of eosinophilia. The observed plateau of risks around 1.0 × 109/l is important for physicians encountering patients with eosinophilia since even mild-to-moderate eosinophilia according to traditional definitions confers maximally increased risks of subsequent/subclinical hematological malignancy

KW - blood

KW - semrap-2014-3

U2 - 10.1002/ajh.23916

DO - 10.1002/ajh.23916

M3 - Journal article

C2 - 25488524

SN - 0361-8609

VL - 90

SP - 225

EP - 229

JO - American Journal of Hematology

JF - American Journal of Hematology

IS - 3

ER -