case of t-cell lymphoproliferative disorder associated with hypereosinophilia with excellent response to mycophenolate mofetil

Hypereosinophilic syndrome [HES] is a group of rare blood disorders characterized by a persistent elevation of blood eosinophil count >/= 1.5 * 10[9]/L and clinical manifestations attributable to eosinophilia or tissue hypereosinophilia. Lymphocytic variant of HES [HES-L] is a known subtype according to World Health Organization classification. It is well documented in the literature that patients with HES-L are predisposed to develop T-cell lymphoma. We report a case of T-cell lymphoproliferation associated with hypereosinophilia, which has been successfully treated with mycophenolate mofetil, with resolution of skin lesions and normalization of eosinophil count and immunoglobulin E level. We believe this is a clinically relevant case since this is a rare disease with little known knowledge on its best treatment modality

Hematopoietic cell transplantation for acute lymphoblastic leukemia in adult patients

Acute lymphoblastic leukemia [ALL] consists of precursor B ALL or T ALL phenotypes. In the pediatric population, ALL patients enjoy an 80% long-term survival with the current pediatric chemotherapy protocols as compared with 50% long-term survival in the adult population. In adults, complete remission rates are similar to those of pediatric patients; however, long-term survival is much lower with the majority of deaths attributable to relapsed disease. Postremission consolidation strategies in adults include chemotherapy, autologous, or allogeneic transplant. Pediatric-inspired chemotherapy protocols are being explored as a consolidation modality in adults. Assigning patients to either modality depends on patient and disease characteristics. Here, we review the literature on the use of hematopoietic cell transplantation as a consolidation modality in the treatment of adult ALL