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Leukemia - Eosinophilic - Introduction

Approved by the Cancer.Net Editorial Board, 08/2017

Editorial Note: Please note that this section is currently under review and will be updated soon.

ON THIS PAGE: You will find some basic information about this disease and the parts of the body it may affect. This is the first page of Cancer.Net’s Guide to Eosinophilic Leukemia. Use the menu to see other pages. Think of that menu as a roadmap for this complete guide.

Leukemia is a cancer of the blood cells. Leukemia begins when healthy blood cells change and grow out of control.

About blood cells

Blood cells are made in the bone marrow, the spongy tissue inside the larger bones in the body. Changes in the bone marrow cells can cause too many or too few of certain blood cells.

There are different types of blood cells:

  • Red blood cells that carry oxygen throughout the body

  • White cells that fight infection

  • Platelets that help the blood to clot

About leukemia

Types of leukemia are named after the specific blood cell that becomes cancerous, such as lymphoid or myeloid cells. Lymphoid cells are a type of white blood cell. Myeloid cells are bone marrow cells that turn into the cells that fight bacterial infections.

There are 4 main types of leukemia in adults:

About eosinophilia and eosinophilic leukemia

Eosinophilia is a condition that develops when the bone marrow makes too many eosinophils, a type of white blood cell. People can have many eosinophils without having leukemia. For example, sometimes the body makes too many eosinophils because of an allergy or an infection with a parasite. This type of eosinophilia is called secondary, or reactive, eosinophilia and is much more common than eosinophilic leukemia.

Chronic eosinophilic leukemia is a subtype of clonal eosinophilia, meaning it is caused by a new genetic mutation or change in the blood cells. It is sometimes called hypereosinophilic syndrome (HES). This disease is classified as a myeloproliferative neoplasm (MPN). Myelo- means bone marrow and proliferative means too much blood cell growth.

This section focuses on chronic eosinophilic leukemia. Acute eosinophilic leukemia is very rare and is treated similarly to acute myeloid leukemia (AML)

Looking for More of an Introduction?

If you would like more of an introduction, explore this related item. Please note that this link will take you to another section on Cancer.Net:

  • Cancer.Net Patient Education Video: View a short video led by an ASCO expert in leukemia that provides basic information and areas of research.

The next section in this guide is Statistics, which explains that eosinophilic leukemia is rare. You may use the menu to choose a different section to read in this guide.

Leukemia - Eosinophilic - Statistics

Approved by the Cancer.Net Editorial Board, 02/2023

Eosinophilic leukemia is rare. No specific statistics are available. Talk with your doctor if you have any questions about your personal diagnosis, incidence of this disease, and your prognosis.

It is important to remember that statistics on the survival rates for people with any type of cancer are an estimate. Learn more about understanding statistics.

The next section in this guide is Risk Factors. It describes the factors that may increase the chance of developing eosinophilic leukemia. Use the menu to choose a different section to read in this guide.

Leukemia - Eosinophilic - Risk Factors

Approved by the Cancer.Net Editorial Board, 08/2017

ON THIS PAGE: You will find out more about the factors that increase the chance of developing eosinophilic leukemia. Use the menu to see other pages.

A risk factor is anything that increases a person’s chance of developing cancer. Although risk factors often influence the development of leukemia, most do not directly cause leukemia. Some people with several risk factors never develop leukemia, while others with no known risk factors do. Knowing your risk factors and talking about them with your doctor may help you make more informed lifestyle and health care choices.

Eosinophilic leukemia can very rarely be caused by a genetic mutation that develops during a person’s life because of environmental factors, smoking, and chemical or radiation exposure. However, no specific cause can be found for most patients with eosinophilic leukemia.

The next section in this guide is Symptoms and Signs. It explains what body changes or medical problems this disease can cause. You may use the menu to choose a different section to read in this guide.

Leukemia - Eosinophilic - Symptoms and Signs

Approved by the Cancer.Net Editorial Board, 08/2017

ON THIS PAGE: You will find out more about body changes and other things that can signal a problem that may need medical care. Use the menu to see other pages. 

People with eosinophilic leukemia may experience the following symptoms or signs. Sometimes, people with eosinophilic leukemia do not have any of these changes. Or, the cause of a symptom may be a different medical condition that is not leukemia.

  • Fever

  • Night sweats

  • Unexplained weight loss

  • Unexplained fatigue or shortness of breath

  • Cough

  • Swollen lymph nodes

  • Muscle pains

  • Itching

  • Diarrhea

  • Feeling full quickly while eating

If you are concerned about any changes you experience, please talk with your doctor. Your doctor will ask how long and how often you’ve been experiencing the symptom(s), in addition to other questions. This is to help figure out the cause of the problem, called a diagnosis.

If eosinophilic leukemia is diagnosed, relieving symptoms remains an important part of care and treatment. This may also be called symptom management, palliative care, or supportive care. Be sure to talk with your health care team about the symptoms you experience, including any new symptoms or a change in symptoms.

The next section in this guide is Diagnosis. It explains what tests may be needed to learn more about the cause of the symptoms. You may use the menu to choose a different section to read in this guide. 

Leukemia - Eosinophilic - Diagnosis

Approved by the Cancer.Net Editorial Board, 08/2017

ON THIS PAGE: You will find a list of common tests, procedures, and scans that doctors use to find the cause of a medical problem. Use the menu to see other pages.

Doctors use many tests to diagnose eosinophilia. Although a patient’s signs and symptoms may cause a doctor to suspect eosinophilic leukemia, it is diagnosed only by testing a patient’s blood and bone marrow. Doctors may also do tests to learn which treatments could work best.

This list describes options for diagnosing eosinophilic leukemia. Not all tests listed below will be used for every person. Your doctor may consider these factors when choosing a diagnostic test:

  • The type of leukemia suspected

  • Your signs and symptoms

  • Your age and medical condition

  • The results of earlier medical tests

The main criteria for diagnosing eosinophilic leukemia are:

  • An eosinophil count in the blood of 1.5 x 109 /L or higher that lasts over time

  • No parasitic infection, allergic reaction, or other causes of eosinophilia

  • Problems with the functioning of a person’s organs because of the eosinophilia

In addition to a physical examination, the following tests may be used to diagnose eosinophilic leukemia:

  • Blood tests. The diagnosis of eosinophilic leukemia begins with a test called a complete blood count (CBC). A CBC measures the number of different types of cells in a person's blood. If the blood contains many eosinophils (see criteria above), eosinophilic leukemia is suspected.

  • Bone marrow aspiration and biopsy. These 2 procedures are similar and often done at the same time to examine the bone marrow. Bone marrow has both a solid and liquid part. A bone marrow aspiration removes a sample of fluid with a needle. A bone marrow biopsy is the removal of a small amount of solid tissue using a needle.

    A pathologist then analyzes the sample(s) to determine the number and type of abnormal cells. A pathologist is a doctor who specializes in interpreting laboratory tests and evaluating cells, tissues, and organs to diagnose disease. A common site for a bone marrow aspiration and biopsy is the pelvic bone, which is located in the lower back by the hip. The skin in that area is usually numbed with medication beforehand. Other types of anesthesia (medication to block awareness of pain) may also be used.

    Many immature cells, called blasts, in the bone marrow are a sign of acute rather than chronic eosinophilic leukemia. Acute eosinophilic leukemia is not covered in this article and is treated similarly to AML.

  • Molecular testing. Your doctor may recommend running laboratory tests on the eosinophils to identify specific genes, proteins, and other factors unique to the leukemia. If many eosinophils are found, a molecular genetic analysis should be done to test for a genetic mutation that makes an abnormal protein known as FIP1-like-1/platelet-derived growth factor alpha or FIP1L1-PDGFRa. The types of molecular testing that may be used include:

  • Immunophenotyping, which is the examination of the proteins on the surface of the leukemia cells. It helps the doctor confirm the exact type of leukemia.

  • Cytogenetics, which is the examination of the leukemia cells for abnormalities in the long strands of genes called chromosomes. It also helps the doctor confirm the diagnosis and may help to determine the person’s chance of recovery.

Results of these tests will also help decide whether your treatment options include a type of treatment called targeted therapy (see Treatment Options).

  • Computed tomography (CT or CAT) scan. A CT scan creates a 3-dimensional picture of the inside of the body using x-rays taken from different angles. A computer combines these images into a detailed, cross-sectional view that shows any abnormalities or tumors. A CT scan shows enlarged lymph nodes or a swollen spleen or liver and can be used to measure the size of these organs. Sometimes, a special dye called a contrast medium is given before the scan to provide better detail on the image. This dye can be injected into a patient’s vein or given as a pill to swallow.

  • Evaluation of the heart. People who have many eosinophils for a long time often have problems with heart function and rhythm. The doctor may recommend an electrocardiogram (ECG or EKG) and/or an echocardiogram (ECHO). An EKG is a noninvasive test that looks for abnormal heart rhythms or heart damage. An ECHO is a noninvasive test that looks at the structure and function of the heart using sound waves and an electronic sensor.

After diagnostic tests are done, your doctor will review all of the results with you. If the diagnosis is eosinophilic leukemia, these results also help the doctor describe the disease.

The next section in this guide is Stages. It explains the system doctors use to describe most cancers and how this differs for eosinophilic leukemia. You may use the menu to choose a different section to read in this guide.

Leukemia - Eosinophilic - Stages

Approved by the Cancer.Net Editorial Board, 08/2017

ON THIS PAGE: You will learn about how doctors usually describe the growth or spread of most cancers, called the stage, and how this differs for eosinophilic leukemia. Use the menu to see other pages.

Generally, staging is a way of describing where a cancer is located, if or where it has spread, and whether it is affecting other parts of the body. Unlike most solid tumors, eosinophilic leukemia does not have a formal staging system. However, doctors still use diagnostic tests, such as those discussed in the Diagnosis section, to evaluate eosinophilic leukemia to help decide what kind of treatment is best and predict your prognosis, which is the chance of recovery.

Regular blood tests are the main ways to monitor a person’s recovery from eosinophilic leukemia, including any symptoms related to the disease and the number of immature cells in the bone marrow. Talk with your doctor for more details on how your specific type of leukemia will be evaluated.

Information about the leukemia will help the doctor recommend a specific treatment plan. The next section in this guide is Treatment Options. You may use the menu to choose a different section to read in this guide.

Leukemia - Eosinophilic - Treatment Options

Approved by the Cancer.Net Editorial Board, 08/2017

ON THIS PAGE: You will learn about the different treatments doctors use for people with eosinophilic leukemia. Use the menu to see other pages.

This section tells you the treatments that are the standard of care for this type of leukemia. “Standard of care” means the best treatments known. When making treatment plan decisions, patients are encouraged to consider clinical trials as an option. A clinical trial is a research study that tests a new approach to treatment. Doctors want to learn whether the new treatment is safe, effective, and possibly better than the standard treatment. Clinical trials can test a new drug, a new combination of standard treatments, or new doses of standard drugs or other treatments. Your doctor can help you consider all your treatment options. To learn more about clinical trials, see the About Clinical Trials and Latest Research sections.

Treatment overview

For leukemia, different types of doctors often work together to create a patient’s overall treatment plan that combines different types of treatments. This is called a multidisciplinary team. Cancer care teams include a variety of other health care professionals, such as physician assistants, oncology nurses, social workers, pharmacists, counselors, dietitians, and others.

According to the National Cancer Institute, the best treatment for eosinophilic leukemia remains unclear. As explained in the Introduction, eosinophilic leukemia is classified as an MPN. Descriptions of the most common treatment options for an MPN are listed below. Treatment options and recommendations depend on several factors, including the type of leukemia, possible side effects, and the patient’s preferences and overall health. Usually, MPNs cannot be cured, but there is often effective treatment to control the symptoms over the long term. Take time to learn about all of your treatment options and be sure to ask questions about things that are unclear. Talk with your doctor about the goals of each treatment and what you can expect while receiving the treatment. Learn more about making treatment decisions.

Chemotherapy

Chemotherapy is the use of drugs to destroy cancer cells, usually by ending the cancer cells’ ability to grow and divide. Chemotherapy is given by a medical oncologist, a doctor who specializes in treating cancer with medication, or a hematologist, a doctor who specializes in treating blood disorders.

Systemic chemotherapy gets into the bloodstream to reach cancer cells throughout the body. Common ways to give chemotherapy include an intravenous (IV) tube placed into a vein using a needle or in a pill or capsule that is swallowed (orally).

A chemotherapy regimen, or schedule, usually consists of a specific number of cycles given over a set period of time. A patient may receive 1 drug at a time or combinations of different drugs given at the same time. Chemotherapy used to treat eosinophilic leukemia includes:

  • Hydroxyurea (Droxia, Hydrea)

  • Cyclophosphamide (Neosar)

  • Corticosteroids such as prednisone (multiple brand names)

  • Vincristine (Vincasar)

The side effects of chemotherapy depend on the individual and the dose used, but they can include fatigue, risk of infection, nausea and vomiting, hair loss, loss of appetite, and diarrhea. These side effects usually go away after treatment is finished.

Learn more about the basics of chemotherapy and preparing for treatment. The medications used to treat cancer are continually being evaluated. Talking with your doctor is often the best way to learn about the medications prescribed for you, their purpose, and their potential side effects or interactions with other medications. Learn more about your prescriptions by using searchable drug databases.

Surgery

Surgery to remove the spleen, which also makes white blood cells, is called a splenectomy. This operation may be recommended for some patients. A surgical oncologist is a doctor who specializes in treating cancer using surgery. 

Before surgery, talk with your health care team about the possible side effects from the specific surgery you will have. Learn more about the basics of surgery.

Immunotherapy

Immunotherapy, also called biologic therapy, is designed to boost the body's natural defenses to fight the leukemia. It uses materials made either by the body or in a laboratory to improve, target, or restore immune system function. Recombinant interferon alpha (Alferon, Infergen, Intron A, Roferon-A) is a biologic therapy that is occasionally used to treat eosinophilic leukemia.

Different types of immunotherapy can cause different side effects. Talk with your doctor about possible side effects for the immunotherapy recommended for you. Learn more about the basics of immunotherapy.

Targeted therapy

Targeted therapy is a treatment that targets the leukemia’s specific genes, proteins, or the tissue environment that contributes to leukemia growth and survival. This type of treatment blocks the growth and spread of leukemia cells while limiting damage to healthy cells.

Recent studies show that not all cancers have the same targets. To find the most effective treatment, your doctor may run tests to identify the genes, proteins, and other factors involved in your leukemia. This helps doctors better match each patient with the most effective treatment whenever possible. In addition, many research studies are taking place now to find out more about specific molecular targets and new treatments directed at them. Learn more about the basics of targeted treatments.

In many patients with hypereosinophilic syndrome, the leukemia cells have a specific genetic change that makes an abnormal protein called the FIP1-like-1/platelet-derived growth factor alpha. This abnormal protein stimulates the cells to grow.

Imatinib (Gleevec) is a drug that stops enzymes called tyrosine kinases from working and can destroy abnormal eosinophils by blocking the effect of the FIP1-like-1-platelet-derived growth factor alpha protein. Imatinib is more likely to work for patients whose leukemia has this genetic mutation. However, even if the leukemia does not have this mutation, there is still a possibility that the drug will work. For many patients, imatinib can improve blood counts and symptoms very quickly and for many years if the drug is taken on a regular basis.

The main side effects of imatinib include swelling around the eyes, leg swelling, muscle cramping, headache, fatigue, rash, and joint pain.

If this treatment works, it is often continued throughout a person’s lifetime. For patients who are not able to take imatinib or if imatinib stops working, the drugs nilotinib (Tasigna) or dasatinib (Sprycel) may be other options.

Talk with your doctor about possible side effects for a specific medication and how they can be managed.

Stem cell transplantation/bone marrow transplantation

A stem cell transplant is a medical procedure in which bone marrow that contains cancer is replaced by highly specialized cells, called hematopoietic stem cells that develop into healthy bone marrow. Hematopoietic stem cells are blood-forming cells found both in the bloodstream and in the bone marrow. Today, this procedure is more commonly called a stem cell transplant, rather than bone marrow transplant, because it is the stem cells in the blood that are typically being transplanted, not the actual bone marrow tissue.

Before recommending transplantation, doctors will talk with the patient about the risks of this treatment and consider several other factors, such as the type of leukemia, results of any previous treatment, and the patient’s age and general health.

Transplantation is a higher-risk treatment and is not used often for people with eosinophilic leukemia because it is not always effective for this disease and because many patients with this disease are older and the risks of the procedure are higher.

There are 2 types of stem cell transplantation depending on the source of the replacement blood stem cells: allogeneic (ALLO) and autologous (AUTO). ALLO uses donated stem cells, while AUTO uses the patient’s own stem cells. In both types, the goal is to destroy all of the leukemia cells in the marrow, blood, and other parts of the body using high doses of chemotherapy and/or radiation therapy and then allow replacement blood stem cells to create healthy bone marrow.

Side effects depend on the type of transplant, your general health, and other factors. Learn more about the basics of stem cell and bone marrow transplantation

Getting care for symptoms and side effects

Leukemia and its treatment often cause side effects. In addition to treatments intended to slow, stop, or eliminate the disease, an important part of care is relieving a person’s symptoms and side effects. This approach is called palliative or supportive care, and it includes supporting the patient with his or her physical, emotional, and social needs.

Palliative care is any treatment that focuses on reducing symptoms, improving quality of life, and supporting patients and their families. Any person, regardless of age or type and stage of cancer, may receive palliative care. It works best when palliative care is started as early as needed in the cancer treatment process. People often receive treatment for the leukemia at the same time that they receive treatment to ease side effects. In fact, patients who receive both at the same time often have less severe symptoms, better quality of life, and report they are more satisfied with treatment.

Palliative treatments vary widely and often include medication, nutritional changes, relaxation techniques, emotional support, and other therapies. You may also receive palliative treatments similar to those meant to eliminate the leukemia, such as chemotherapy or surgery. Talk with your doctor about the goals of each treatment in the treatment plan.

Palliative care for eosinophilic leukemia may include the following treatments:

  • Steroids. Steroid medications are used to control some symptoms of eosinophilic leukemia.

  • Radiation therapy. Radiation therapy is the use of high-energy x-rays or other particles to destroy cancer cells. A doctor who specializes in giving radiation therapy to treat cancer is called a radiation oncologist. The most common type of radiation therapy is called external-beam radiation therapy, which is radiation given from a machine outside the body. When radiation therapy is given using implants, it is called internal radiation therapy or brachytherapy. A radiation therapy regimen, or schedule, usually consists of a specific number of treatments given over a set period of time. Side effects from radiation therapy include fatigue, mild skin reactions, upset stomach, and loose bowel movements. Most side effects go away soon after treatment is finished.  Learn more about the basics of radiation therapy.

Before treatment begins, talk with your health care team about the possible side effects of your specific treatment plan and palliative care options. During and after treatment, be sure to tell your doctor or another health care team member if you are experiencing a problem so it can be addressed as quickly as possible. Learn more about palliative care.   

Refractory eosinophilic leukemia

If the leukemia continues to worsen despite treatment, it is called refractory leukemia. If this happens, it is a good idea to talk with doctors who have experience in treating it. Doctors can have different opinions about the best standard treatment plan. Also, clinical trials might be an option. Learn more about getting a second opinion before starting treatment, so you are comfortable with your chosen treatment plan.

Your treatment plan may include a combination of chemotherapy, targeted therapy, immunotherapy, and bone marrow/stem cell transplantation. Palliative care will also be important to help relieve symptoms and side effects.

For most patients, a diagnosis of refractory leukemia is very stressful and, at times, difficult to bear. Patients and their families are encouraged to talk about the way they are feeling with doctors, nurses, social workers, or other members of the health care team. It may also be helpful to talk with other patients, including through a support group.

Remission and the chance of recurrence

A remission is when leukemia cannot be detected in the body and there are no symptoms. This may also be called having “no evidence of disease” or NED. 

A remission may be temporary or permanent. This uncertainty causes many people to worry that the leukemia will come back. While many remissions are permanent, it’s important to talk with your doctor about the possibility of the leukemia returning. Understanding your risk of recurrence and the treatment options may help you feel more prepared if the disease does return. Learn more about coping with the fear of recurrence.

If the leukemia does return after the original treatment, it is called recurrent leukemia. When this occurs, a new cycle of testing will begin again to learn as much as possible about the recurrence. After this testing is done, you and your doctor will talk about your treatment options. Often the treatment plan will include the treatments described above such as chemotherapy, immunotherapy, targeted therapy, or stem cell transplantation, but they may be used in a different combination or given at a different pace. Your doctor may suggest clinical trials that are studying new ways to treat this type of recurrent leukemia. Whichever treatment plan you choose, palliative care will be important for relieving symptoms and side effects.

People with recurrent leukemia often experience emotions such as disbelief or fear. Patients are encouraged to talk with their health care team about these feelings and ask about support services to help them cope. Learn more about dealing with a recurrence.

If treatment doesn’t work

Recovery from leukemia is not always possible. If the leukemia cannot be cured or controlled, the disease may be called advanced or terminal.

This diagnosis is stressful, and for many people, advanced leukemia is difficult to discuss. However, it is important to have open and honest conversations with your doctor and health care team to express your feelings, preferences, and concerns. The health care team is there to help, and many team members have special skills, experience, and knowledge to support patients and their families. Making sure a person is physically comfortable and free from pain is extremely important.

Patients who have advanced leukemia and who are expected to live less than 6 months may want to consider a type of palliative care called hospice care. Hospice care is designed to provide the best possible quality of life for people who are near the end of life. You and your family are encouraged to talk with the health care team about hospice care options, which include hospice care at home, a special hospice center, or other health care locations. Nursing care and special equipment can make staying at home a workable option for many families. Learn more about advanced cancer care planning.

After the death of a loved one, many people need support to help them cope with the loss. Learn more about grief and loss.

The next section in this guide is About Clinical Trials. It offers more information about research studies that are focused on finding better ways to care for people with cancer. You may use the menu to choose a different section to read in this guide.

Leukemia - Eosinophilic - About Clinical Trials

Approved by the Cancer.Net Editorial Board, 08/2017

ON THIS PAGE: You will learn more about clinical trials, which are the main way that new medical approaches are tested to see how well they work. Use the menu to see other pages.

What are clinical trials?

Doctors and scientists are always looking for better ways to care for patients with eosinophilic leukemia. To make scientific advances, doctors create research studies involving volunteers, called clinical trials. In fact, every drug that is now approved by the U.S. Food and Drug Administration (FDA) was tested in clinical trials.

Many clinical trials focus on new treatments. Researchers want to learn if a new treatment is safe, effective, and possibly better than the treatment doctors use now. These types of studies evaluate new drugs, different combinations of existing treatments, new approaches to radiation therapy or surgery, and new methods of treatment. Patients who participate in clinical trials can be some of the first to get a treatment before it is available to the public. However, there are some risks with a clinical trial, including possible side effects and that the new treatment may not work. People are encouraged to talk with their health care team about the pros and cons of joining a specific study.

Some clinical trials study new ways to relieve symptoms and side effects during treatment. Others study ways to manage the late effects that may happen a long time after treatment. Talk with your doctor about clinical trials for symptoms and side effects. There are also clinical trials studying ways to prevent leukemia.

Deciding to join a clinical trial

Patients decide to participate in clinical trials for many reasons. For some patients, a clinical trial is the best treatment option available. Because standard treatments are not perfect, patients are often willing to face the added uncertainty of a clinical trial in the hope of a better result. Other patients volunteer for clinical trials because they know that these studies are a way to contribute to the progress in treating eosinophilic leukemia. Even if they do not benefit directly from the clinical trial, their participation may benefit patients with eosinophilic leukemia in the future.

Insurance coverage of clinical trials costs differs by location and by study. In some programs, some of the patient’s expenses from participating in the clinical trial are reimbursed. In others, they are not. It is important to talk with the research team and your insurance company first to learn if and how your treatment in a clinical trial will be covered. Learn more about health insurance coverage of clinical trials.

Sometimes people have concerns that, in a clinical trial, they may receive no treatment by being given a placebo or a “sugar pill.” Placebos are usually combined with standard treatment in most cancer clinical trials. When a placebo is used in a study, it is done with the full knowledge of the participants. Find out more about placebos in cancer clinical trials.

Patient safety and informed consent

To join a clinical trial, patients must participate in a process known as informed consent. During informed consent, the doctor should:

  • Describe all of the patient’s options, so that the person understands how the new treatment differs from the standard treatment.

  • List all of the risks of the new treatment, which may or may not be different from the risks of standard treatment.

  • Explain what will be required of each patient in order to participate in the clinical trial, including the number of doctor visits, tests, and the schedule of treatment.

Clinical trials also have certain rules called “eligibility criteria” that help structure the research and keep patients safe. You and the research team will carefully review these criteria together.

Patients who participate in a clinical trial may stop participating at any time for any personal or medical reason. This may include that the new treatment is not working or there are serious side effects. Clinical trials are also closely monitored by experts who watch for any problems with each study. It is important that patients participating in a clinical trial talk with their doctor and researchers about who will be providing their treatment and care during the clinical trial, after the clinical trial ends, and/or if the patient chooses to leave the clinical trials before it ends.

Finding a clinical trial

Research through clinical trials is ongoing for all types of cancer. For specific topics being studied for leukemia, learn more in the Latest Research section.

Cancer.Net offers a lot of information about clinical trials in other areas of the website, including a complete section on clinical trials and places to search for clinical trials for a specific type of leukemia.

PRE-ACT, Preparatory Education About Clinical Trials

In addition, this website offers free access to a video-based educational program about cancer clinical trials, located outside of this guide.

The next section in this guide is Latest Research. It explains areas of scientific research currently going on for eosinophilic leukemia. You may use the menu to choose a different section to read in this guide.    

Leukemia - Eosinophilic - Latest Research

Approved by the Cancer.Net Editorial Board, 08/2017

ON THIS PAGE: You will read about the scientific research being done now to learn more about eosinophilic leukemia and how to treat it. Use the menu to see other pages.

Doctors are working to learn more about eosinophilic leukemia, ways to prevent it, how to best treat it, and how to provide the best care to people diagnosed with this disease. The following areas of research may include new options for patients through clinical trials. Always talk with your doctor about the best diagnostic and treatment options for you.

  • Genetic research. Because this type of disorder is usually associated with a genetic mutation, researchers are searching for specific genes or mutations that can trigger eosinophilic leukemia and could be targeted by new drugs.

  • Stem cell/bone marrow transplantation. New approaches for stem cell/bone marrow transplantation (see Treatment Options) are being tested to increase the use of this treatment option.

  • New treatments. Other combinations of chemotherapy and other treatment combinations are also being studied, as is the drug mepolizumab (Nucala). Early studies have shown that mepolizumab lowers the number of eosinophils for people with allergies and HES. It has also helped control some signs and symptoms of HES.

  • Palliative care. Clinical trials are underway to find better ways of reducing symptoms and side effects of current eosinophilic leukemia treatments to improve patients’ comfort and quality of life.

Looking for More About the Latest Research?

If you would like additional information about the latest areas of research regarding leukemia, explore these related items that take you outside of this guide:

The next section in this guide is Coping with Treatment. It offers some guidance in how to cope with the physical, emotional, and social changes that leukemia and its treatment can bring. You may use the menu to choose a different section to read in this guide.

Leukemia - Eosinophilic - Coping with Treatment

Approved by the Cancer.Net Editorial Board, 08/2017

ON THIS PAGE: You will learn more about coping with the physical, emotional, social, and financial effects of leukemia and its treatment. This page includes several links outside of this guide to other sections of this website. Use the menu to see other pages.

Every treatment for leukemia can cause side effects or changes to your body and how you feel. For many reasons, people don’t experience the same side effects even when they are given the same treatment for the same type of leukemia. This can make it hard to predict how you will feel during treatment.

As you prepare to start treatment, it is normal to fear treatment-related side effects. It may help to know that your health care team will work to prevent and relieve side effects. Doctors call this part of treatment “palliative care.” It is an important part of your treatment plan, regardless of your age or the stage of disease.

Coping with physical side effects

Common physical side effects from each treatment option for eosinophilic leukemia are described within the Treatment Options section. Learn more about side effects of leukemia and its treatment, along with ways to prevent or control them. Changes to your physical health depend on several factors, including the leukemia’s stage, the length and dose of treatment, and your general health.

Sometimes, physical side effects can last after treatment ends. Doctors call these long-term side effects. They call side effects that occur months or years after treatment late effects. Treating long-term side effects and late effects is an important part of survivorship care. Learn more by reading the Follow-up Care section of this guide or talking with your doctor.

Coping with emotional and social effects

You can have emotional and social effects as well as physical effects after a diagnosis of eosinophilic leukemia. This may include dealing with difficult emotions, such as sadness, anxiety, or anger, or managing your stress level. Sometimes, patients have problems expressing how they feel to their loved ones, or people don’t know what to say in response.

Patients and their families are encouraged to share their feelings with a member of their health care team. You can also find coping strategies for emotional and social effects in a separate section of this website. This section includes many resources for finding support and information to meet your needs.

Coping with financial effects

Treatment for leukemia can be expensive. It is often a big source of stress and anxiety for people with leukemia and their families. In addition to treatment costs, many people find they have extra, unplanned expenses related to their care. For some people, the high cost stops them from following or completing their treatment plan. This can put their health at risk and may lead to higher costs in the future. Patients and their families are encouraged to talk about financial concerns with a member of their health care team. Learn more about managing financial considerations, in a separate part of this website.

Caring for a loved one with leukemia

Family members and friends often play an important role in taking care of a person with eosinophilic leukemia. This is called being a caregiver. Caregivers can provide physical, practical, and emotional support to the patient, even if they live far away.

Caregivers may have a range of responsibilities on a daily or as-needed basis. Below are some of the responsibilities caregivers take care of:

  • Providing support and encouragement

  • Giving medications

  • Helping manage symptoms and side effects

  • Coordinating medical appointments

  • Providing a ride to appointments

  • Assisting with meals

  • Helping with household chores

  • Handling insurance and billing issues

Learn more about caregiving.

Talking with your health care team about side effects

Before starting treatment, talk with your doctor about possible side effects. Ask:

  • Which side effects are most likely?

  • When are they are likely to happen?

  • What can we do to prevent or relieve them?

Be sure to tell your health care team about any side effects that happen during treatment and afterward, too. Tell them even if you don’t think the side effects are serious. This discussion should include physical, emotional, and social effects of leukemia.

Also, ask how much care you may need at home and with daily tasks during and after treatment. This can help you make a caregiving plan.

The next section in this guide is Follow-up Care. It explains the importance of checkups after treatment for eosinophilic leukemia is finished. You may use the menu to choose a different section to read in this guide.

Leukemia - Eosinophilic - Follow-Up Care

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ON THIS PAGE: You will read about your medical care after treatment is completed, and why this follow-up care is important. Use the menu to see other pages.

Care for people diagnosed with eosinophilic leukemia doesn’t end when active treatment has finished. Your health care team will continue to check to make sure the leukemia has not returned, manage any side effects, and monitor your overall health. This is called follow-up care.

Your follow-up care may include regular physical examinations, blood tests, bone marrow biopsies, and possibly scans or other imaging studies. Doctors want to keep track of your recovery in the months and years ahead. People experiencing a long-term remission are encouraged to follow cancer screening recommendations for the general population.

Learn more about the importance of follow-up care.

Watching for recurrence

One goal of follow-up care is to check for a recurrence. Leukemia recurs because small areas of leukemia cells may remain undetected in the body. Over time, these cells may increase in number until they show up on test results or cause signs or symptoms. During follow-up care, a doctor familiar with your medical history can give you personalized information about your risk of recurrence. Your doctor will ask specific questions about your health. Some people may have blood tests or imaging tests done as part of regular follow-up care, but testing recommendations depend on several factors including the type of leukemia originally diagnosed and the types of treatment given.

The anticipation before having a follow-up test or waiting for test results can add stress to you or a family member. This is sometimes called “scan-xiety.” Learn more about how to cope with this type of stress.

Managing long-term and late side effects

Most people expect to experience side effects when receiving treatment. However, it is often surprising to survivors that some side effects may linger beyond the treatment period. These are called long-term side effects. Other side effects called late effects may develop months or even years afterwards. Long-term and late effects can include both physical and emotional changes.

Some eosinophilic leukemia treatments may cause the following long-term side effects.

  • Numbness, tingling, and pain in the hands and feet from vincristine.

  • A weakened heart muscle from higher total doses of doxorubicin (Adriamycin) or radiation therapy to the chest.

  • A secondary leukemia or another type of secondary cancer is more common after chemotherapy and radiation therapy.

Talk with your doctor about your risk of developing such side effects based on the type of leukemia, your individual treatment plan, and your overall health. If you had a treatment known to cause specific late effects, you may have certain physical examinations, scans, or blood tests to help find and manage them.

Keeping personal health records

You and your doctor should work together to develop a personalized follow-up care plan. Be sure to discuss any concerns you have about your future physical or emotional health. ASCO offers forms to help create a treatment summary to keep track of the treatment you received and develop a survivorship care plan when treatment is completed.

This is also a good time to decide who will lead your follow-up care. Some survivors continue to see their oncologist, while others transition back to the care of their family doctor or another health care professional. This decision depends on several factors, including the type of leukemia, side effects, health insurance rules, and your personal preferences.

If a doctor who was not directly involved in your care for eosinophilic leukemia will lead your follow-up care, be sure to share your treatment summary and survivorship care plan forms with him or her and with all future health care providers. Details about your treatment are very valuable to the health care professionals who will care for you throughout your lifetime.

The next section in this guide is Survivorship. It describes how to cope with challenges in everyday life after a diagnosis of eosinophilic leukemia. You may use the menu to choose a different section to read in this guide.  

Leukemia - Eosinophilic - Survivorship

Approved by the Cancer.Net Editorial Board, 08/2017

ON THIS PAGE: You will read about how to cope with challenges in everyday life after a diagnosis of eosinophilic leukemia. Use the menu to see other pages.

What is survivorship?

The word “survivorship” means different things to different people. Common definitions include:

  • Having no signs of cancer after finishing treatment.

  • Living with, through, and beyond cancer. According to this definition, survivorship begins at diagnosis and includes people who continue to have treatment over the long term, to either reduce the risk of recurrence or to manage chronic disease.

Survivorship is one of the most complicated parts of having leukemia. This is because it is different for everyone.  

Survivors may experience a mixture of strong feelings, including joy, concern, relief, guilt, and fear. Some people say they appreciate life more after the diagnosis and have gained a greater acceptance of themselves. Others become very anxious about their health and uncertain about coping with everyday life.

Survivors may feel some stress when their frequent visits to the health care team end after completing treatment. Often, relationships built with the health care team provide a sense of security during treatment, and people miss this source of support. This may be especially true when new worries and challenges surface over time, such as any late effects of treatment, emotional challenges including fear of recurrence, sexuality and fertility concerns, and financial and workplace issues.

Every survivor has individual concerns and challenges. With any challenge, a good first step is being able to recognize your fears and talk about them. Effective coping requires:

  • Understanding the challenge you are facing

  • Thinking through solutions

  • Asking for and allowing the support of others

  • Feeling comfortable with the course of action you choose

Many survivors find it helpful to join an in-person support group or an online community of survivors. This allows you to talk with people who have had similar first-hand experiences. Other options for finding support include talking with a friend or member of your health care team, individual counseling, or asking for assistance at the learning resource center of the place where you received treatment.

Changing role of caregivers

Family members and friends may also go through periods of transition. A caregiver plays a very important role in supporting a person diagnosed with leukemia, providing physical, emotional, and practical care on a daily or as-needed basis. Many caregivers become focused on providing this support, especially if the treatment period lasts for many months or longer.

However, as treatment is completed, the caregiver's role often changes. Eventually, the need for caregiving related to the diagnosis will become much less or come to an end. Caregivers can learn more about adjusting to life after caregiving in this article.

A new perspective on your health

For many people, survivorship serves as a strong motivator to make positive lifestyle changes.

People recovering from eosinophilic leukemia are encouraged to follow established guidelines for good health, such as not smoking, limiting alcohol, eating well, and managing stress. Regular physical activity can help rebuild your strength and energy level. Your health care team can help you create an appropriate exercise plan based upon your needs, physical abilities, and fitness level. Learn more about making healthy lifestyle choices.

It is important to have recommended medical checkups and tests (see Follow-up Care) to take care of your health. Rehabilitation may be recommended, and this could mean any of a wide range of services such as physical therapy, career counseling, pain management, nutritional planning, and/or emotional counseling. The goal of rehabilitation is to help people regain control over many aspects of their lives and remain as independent and productive as possible.

Talk with your doctor to develop a survivorship care plan that is best for your needs.

Looking for More Survivorship Resources?

For more information about survivorship, explore these related items. Please note that these links will take you to other sections of Cancer.Net:

  • ASCO Answers Cancer Survivorship Guide: Get this 44-page booklet that helps people transition into life after treatment. It includes blank treatment summary and survivorship care plan forms. The booklet is available as a PDF, so it is easy to print out.

  • Cancer.Net Patient Education Video: View a short video led by an ASCO expert that provides information about what comes next after finishing treatment.

  • Survivorship Resources: Cancer.Net offers an entire area of this website with resources to help survivors, including those in different age groups.

The next section offers Questions to Ask the Health Care Team to help start conversations with your health care team. You may use the menu to choose a different section to read in this guide.

Leukemia - Eosinophilic - Questions to Ask the Doctor

Approved by the Cancer.Net Editorial Board, 08/2017

ON THIS PAGE: You will find some questions to ask your doctor or other members of your health care team, to help you better understand your diagnosis, treatment plan, and overall care. Use the menu to see other pages.

Talking often with your health care team is important to make informed decisions about your health care. These suggested questions are a starting point to help you learn more about your care and treatment. You are also encouraged to ask additional questions that are important to you. You may want to print this list and bring it to your next appointment, or download Cancer.Net’s free mobile app for a digital list and other interactive tools to manage your care.

Questions to ask after getting a diagnosis

  • What type of leukemia do I have?

  • Can you explain my pathology report (laboratory rest results) to me?

  • How will the disease develop? Is it possible to slow or delay this development?

  • How can my symptoms be controlled? For how long?

  • Are other members of my family at risk for developing leukemia?

Questions to ask about choosing a treatment and managing side effects

  • What are my treatment options?

  • What clinical trials are available for me? Where are they located, and how do I find out more about them?

  • What treatment plan do you recommend? Why?

  • What is the goal of each treatment? Is it to eliminate the leukemia, manage the symptoms and side effects, or both?

  • Who will be part of my health care team, and what does each member do?

  • Who will be leading my overall treatment?

  • What are the possible side effects of this treatment, both in the short term and the long term?

  • How will this treatment affect my daily life? Will I be able to work, exercise, and perform my usual activities?

  • Could this treatment affect my sex life? If so, how and for how long?

  • Could this treatment affect my ability to become pregnant or have children? If so, should I talk with a fertility specialist before treatment begins?

  • If I’m worried about managing the costs of medical care, who can help me?

  • How can I keep myself as healthy as possible during treatment?

  • What support services are available to me? To my family?

  • Whom should I call with questions or problems?

Questions to ask about having chemotherapy, immunotherapy, or targeted therapy

  • What type of treatment is recommended?

  • What is the goal of this treatment?

  • How long will it take to give this treatment?

  • What side effects can I expect during treatment?

  • What are the possible long-term effects of having this treatment?

  • What can be done to relieve the side effects?

  • Are other members of my family at risk for developing leukemia?

Questions to ask about planning follow-up care

  • What is the chance that the leukemia will come back? Should I watch for specific signs or symptoms?

  • What long-term side effects or late effects are possible based on the treatment I received?

  • What follow-up tests will I need, and how often will I need them?

  • How do I get a treatment summary and survivorship care plan to keep in my personal records?

  • Who will be leading my follow-up care?

  • What survivorship support services are available to me? To my family?

The next section in this guide is Additional Resources. It offers some more resources on this website beyond this guide that may be helpful to you. You may use the menu to choose a different section to read in this guide.

Leukemia - Eosinophilic - Additional Resources

Approved by the Cancer.Net Editorial Board, 08/2017

ON THIS PAGE: You will find some helpful links to other areas of Cancer.Net that provide information about cancer care and treatment. This is the final page of Cancer.Net’s Guide to Eosinophilic Leukemia. Use the menu to go back and see other pages.

Cancer.Net includes many other sections about the medical and emotional aspects of leukemia for the person diagnosed and their family members and friends. This website is meant to be a resource for you and your loved ones from the time of diagnosis, through treatment, and beyond.

Beyond this guide, here are a few links to help you explore other parts of Cancer.Net:

  • To find a range of information and insights from different voices on timely cancer topics, visit the Cancer.Net Blog.

This is the end of Cancer.Net’s Guide to Eosinophilic Leukemia. You may use the menu to choose a different section to read in this guide.