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Chapter 35: Basophils and Mast Cells and Their Diseases

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    Basophils and Mast Cells and Their Diseases. In: Lichtman MA, Kaushansky K, Kipps TJ, Prchal JT, Levi MM. Lichtman M.A., Kaushansky K, Kipps T.J., Prchal J.T., Levi M.M. Eds. Marshall A. Lichtman, et al.eds. Williams Manual of Hematology, 8e New York, NY: McGraw-Hill; . http://hemonc.mhmedical.com/content.aspx?bookid=1783&sectionid=121721166. Accessed November 17, 2019.
    MLA Citation
    . "Basophils and Mast Cells and Their Diseases." Williams Manual of Hematology, 8e Lichtman MA, Kaushansky K, Kipps TJ, Prchal JT, Levi MM. Lichtman M.A., Kaushansky K, Kipps T.J., Prchal J.T., Levi M.M. Eds. Marshall A. Lichtman, et al. New York, NY: McGraw-Hill, , http://hemonc.mhmedical.com/content.aspx?bookid=1783&sectionid=121721166.

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BASOPHILIA

  • Normal basophil count is 0.015 to 0.08 × 109/L.

  • The causes of basophilia are listed in Table 35–1.

  • An increase in the absolute basophil count among other blood cell abnormalities may be a useful sign of a chronic clonal myeloid disease (see Table 35–1).

  • In chronic myelogenous leukemia (CML), an increased absolute basophil count occurs in virtually all patients.

  • De novo acute basophilic leukemia is very rare, but marrow basophilia may be associated uncommonly with other subtypes of acute myelogenous or acute promyelocytic leukemia (see Table 35–2).

  • Basophils in acute or chronic clonal myeloid diseases are derived from the malignant clone and occasionally may cause symptoms of histamine release (flushing, pruritus, hypotension) or severe peptic ulcer disease reflecting hypersecretion of gastric acid and pepsin.

TABLE 35–1CONDITIONS ASSOCIATED WITH ALTERATIONS IN NUMBERS OF BLOOD
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TABLE 35–1 CONDITIONS ASSOCIATED WITH ALTERATIONS IN NUMBERS OF BLOOD

Basophils

  1. Decreased Numbers (Basopenia)

    1. Hereditary absence of basophils (very rare)

    2. Elevated levels of glucocorticoids

    3. Hyperthyroidism or treatment with thyroid hormones

    4. Ovulation

    5. Hypersensitivity reactions

      1. Urticaria

      2. Anaphylaxis

      3. Drug-induced reactions

    6. Leukocytosis (in association with diverse disorders)

  2. Increased Numbers (Basophilia)

    1. Allergy or inflammation

    2. Ulcerative colitis

    3. Drug, food, inhalant hypersensitivity

    4. Erythroderma, urticaria

    5. Juvenile rheumatoid arthritis

    6. Endocrinopathy

      1. Diabetes mellitus

      2. Estrogen administration

      3. Hypothyroidism (myxedema)

    7. Infection

      1. Chicken pox

      2. Influenza

      3. Smallpox

      4. Tuberculosis

    8. Iron deficiency

    9. Exposure to ionizing radiation

    10. Neoplasia

      1. "Basophilic leukemias" (see text)

      2. Myeloproliferative neoplasms (especially chronic myelogenous leukemia; also polycythemia vera, primary myelofibrosis, essential thrombocythemia)

      3. Carcinoma

Source: Williams Hematology, 8th ed, Chap. 63, Table 63–2, p. 921.

TABLE 35–2LEUKEMIAS ASSOCIATED WITH STRIKING BASOPHILIA
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TABLE 35–2 LEUKEMIAS ASSOCIATED WITH STRIKING BASOPHILIA

  1. Chronic myelogenous leukemia with exaggerated basophilia

  2. Blast transformation of chronic myelogenous leukemia, including acute basophilic transformation, of chronic myelogenous leukemia

  3. Acute myeloid leukemia with t(9;22), t(6;9), t(3;6) or 12p abnormalities and marrow basophilia

  4. Acute promyelocytic leukemia with basophilic maturation

  5. Acute basophilic leukemia

Source: Williams Hematology, 8th ed, Chap. 63, Table 63–3, p. 922.

BASOPHILOPENIA

MAST CELLS

  • Mast cells are produced in the marrow, transit the blood to the tissues where they reside. They cannot be identified in transit in the blood of healthy individuals by standard techniques.

  • Mast cells contain mediators that may be preformed in granules (e.g., histamine, heparin, and chemotactic factors) or newly formed (e.g., arachidonic acid metabolites, such as prostaglandin D2 and leukotrienes).

REACTIVE MASTOCYTOSIS

  • An increased number of mast cells may be seen in any tissue involved in a hypersensitivity reaction.

  • An increased number may be seen in the lymph nodes and marrow as a reaction to a variety of benign and malignant tumors.

BENIGN MAST CELL DISEASES

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