HES therapy
| Drug . | Usual dosing . | Side effects* . | Comments . |
|---|---|---|---|
| Imatinib | 100-400 mg orally | Cytopenias, hepatitis, diarrhea, edema, necrotizing myocarditis | First line for PDGFR-associated myeloid neoplasms, second line for other forms of MHES |
| Prednisone | Varied, oral, swallowed, or intravenous | Weight gain, osteopenia, diabetes, mood disturbance | First line for most PDGFR-negative HES; adjunct for PDGFRA positive with cardiac involvement |
| Hydroxyurea | 1-2 g/d, oral | Cytopenias, diarrhea | Second line for idiopathic HES and PDGFRA-negative MHES; low dose may potentiate activity of interferon-α |
| Interferon-α | 1-3 mU subcutaneously daily or 3 times per week; varied (pegylated) | Flu-like symptoms, depression, cytopenias, hypothyroidism, neuropathy, liver toxicity | Second line for all forms of HES; preferred second line for LHES |
| Methotrexate | 7.5-20 mg weekly, orally or subcutaneously | Cytopenias, liver toxicity, pneumonitis, desquamative skin rash, encephalopathy, secondary malignancy | Alternative second-line agent for EGPA, HES with pulmonary involvement |
| Cyclosporine | 150 mg daily orally | Nephrotoxicity, hypertension, neurotoxicity, secondary malignancy | Little data to support use in HES, although anecdotal reports of efficacy in LHES |
| Drug . | Usual dosing . | Side effects* . | Comments . |
|---|---|---|---|
| Imatinib | 100-400 mg orally | Cytopenias, hepatitis, diarrhea, edema, necrotizing myocarditis | First line for PDGFR-associated myeloid neoplasms, second line for other forms of MHES |
| Prednisone | Varied, oral, swallowed, or intravenous | Weight gain, osteopenia, diabetes, mood disturbance | First line for most PDGFR-negative HES; adjunct for PDGFRA positive with cardiac involvement |
| Hydroxyurea | 1-2 g/d, oral | Cytopenias, diarrhea | Second line for idiopathic HES and PDGFRA-negative MHES; low dose may potentiate activity of interferon-α |
| Interferon-α | 1-3 mU subcutaneously daily or 3 times per week; varied (pegylated) | Flu-like symptoms, depression, cytopenias, hypothyroidism, neuropathy, liver toxicity | Second line for all forms of HES; preferred second line for LHES |
| Methotrexate | 7.5-20 mg weekly, orally or subcutaneously | Cytopenias, liver toxicity, pneumonitis, desquamative skin rash, encephalopathy, secondary malignancy | Alternative second-line agent for EGPA, HES with pulmonary involvement |
| Cyclosporine | 150 mg daily orally | Nephrotoxicity, hypertension, neurotoxicity, secondary malignancy | Little data to support use in HES, although anecdotal reports of efficacy in LHES |
Not inclusive.