Chronic Eosinophilic Leukemia with FIP1L1-PDGFRA Transcripts after Occupational and Therapeutic Exposure to Radiation

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 leukaemia 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 14.2 × 10⁹/L, bone marrow and lymph node involvement. Treatment with Imatinib was initiated, resulting in complete haematological 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 for the clinical heterogeneity of FIP1L1-PDGFA–positive myeloproliferative neoplasms and the possible role of occupational and therapeutic radiation, raising the question if one or both of them might be the causative factor.