Chronic Neutrophilic Leukemia: Description of a New Case with Karyotypic Abnormalities

Donato, Carlo Di; Croci, Gianfranco; Lazzari, Stefano; Scarduelli, Laura; R, Vignoli; Buia, Marco; Tramaloni, Casimiro; Maccari, Sergio; Plancher, Angelo Cesare

doi:10.1093/ajcp/85.3.369

Cited by 30 publications

(21 citation statements)

References 6 publications

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“…The origin of the neoplastic clone in CNL has long been considered to be from granulocyte-committed progenitors, 19 and this was recently demonstrated by Yanagisawa et al 7 in an elegant study using colony-forming progenitor cell assays combined with cytogenetic analysis. They reported a patient with CNL who had complex chromosomal abnormalities without evidence of t(9;22) translocation or the BCR/ABL rearrangement.…”

Section: Discussionmentioning

confidence: 98%

Chronic neutrophilic leukemia (CNL): a clinical, pathologic and cytogenetic study

et al. 2001

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This report describes a single institution's recent experience with six patients fulfilling the diagnostic criteria of chronic neutrophilic leukemia. No patient had the Philadelphia chromosome or the BCR/ABL fusion gene. None of the common cytogenetic abnormalities characteristic of myeloid disorders were detected. Two patients demonstrated clonal evolution during the course of the disease. All responded initially to therapy with hydroxyurea with control of leukocytosis and reduction in splenomegaly. Three patients eventually became refractory to hydroxyurea, manifesting progressive neutrophilia without blastic transformation. Aggressive chemotherapy to control progressive leukocytosis resulted in death due to cytopenias in two of these patients. The third patient received less intensive chemotherapy and died of progressive disease. One patient died after transformation of the disease into undifferentiated acute myeloid leukemia. Two patients remain alive with stable disease on hydroxyurea therapy, 12 and 54 months after initial diagnosis. Chronic neutrophilic leukemia is a rare clinicopathologic entity that can be distinguished from chronic myelogenous leukemia, the recently described neutrophilic-chronic myelogenous leukemia, and myelodysplastic syndrome. The clinical course is heterogeneous, with a definite risk of death from either blastic transformation or progressive neutrophilic leukocytosis. Continued study and reporting of these cases must be encouraged. Leukemia (2001) 15, 35-40.

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Section: Discussionmentioning

confidence: 98%

Chronic neutrophilic leukemia (CNL): a clinical, pathologic and cytogenetic study

et al. 2001

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“…By analyzing the X chromo some inactivation pattern, Standen et al [8] demon strated that CNL associated with multiple myeloma can be caused by reactive myeloid proliferation. On the other hand, there have been several case reports that confirmed CNL with Monoclonal Gammopathy Acta Haematol 1996:95:140-143 clonal myeloid proliferation in CNL [9][10][11][12]. Karyotypic abnormality was documented in 3 of these cases [9][10][11].…”

Section: Discussionmentioning

confidence: 99%

Chronic Neutrophilic Leukemia Associated with Monoclonal Gammopathy of Undetermined Significance

Ito

Kojima²,

Otani³

et al. 1996

Acta Haematol

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A 30-year-old man with chronic neutrophilic leukemia (CNL) in association with monoclonal gammopathy is presented. Physical examination on admission revealed moderate hepatosplenomegaly. Initial blood count showed neutrophilic leukocytosis (42.2 × 10⁹/l with 90% mature neutrophils). Leukocyte alkaline phosphatase (LAP) score was elevated. Bone marrow aspiration showed myeloid hyperplasia without dysplastic features. Karyotypic and molecular analyses of bone marrow cells showed the absence of Philadelphia (Ph¹) chromosome and bcr gene rearrangement. Because there was no underlying infection or neoplasm, he was diagnosed as having CNL associated with IgG κ-type monoclonal gammopathy (IgG, 1,269 mg/dl). In addition to its association with monoclonal gammopathy of undetermined significance (MGUS), the present case was also characterized by spontaneous remission of CNL during the 12-year follow-up, accompanied by a gradual increase in serum IgG levels up to 3,000 mg/dl. As far as we know, there have been 19 cases of CNL associated with monoclonal gammopathy in the literature. The median survival of these cases was 5 years. Although there have been only 6 cases of CNL associated with MGUS, survival of these cases was particularly favorable. Taken together with the observation that leukocytosis and hepatosplenomegaly in the present case subsided without specific treatment, we speculate that myeloid proliferation in the present case may have been a leukemoid reaction to underlying monoclonal gammopathy.

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“…However, there are well-characterized cases that do meet the criteria for CNL for which cytogenetic or molecular genetic studies have confirmed clonality of the neutrophil lineage. [97][98][99] In view of these latter reports, the WHO included CNL in the CMPDs, with the recommendation that the possibility of an underlying disease be carefully excluded. If another neoplasm, such as myeloma, is present, the diagnosis of CNL should be made only if there is genetic evidence of a myeloid neoplasm.…”

Section: Chronic Neutrophilic Leukemia (Cnl)mentioning

confidence: 99%

The World Health Organization (WHO) classification of the myeloid neoplasms

Vardiman

Harris²,

Brunning³

2002

Blood

1,914

1,288

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A World Health Organization (WHO) classification of hematopoietic and lymphoid neoplasms has recently been published. This classification was developed through the collaborative efforts of the Society for Hematopathology, the European Association of Hematopathologists, and more than 100 clinical hematologists and scientists who are internationally recognized for their expertise in hematopoietic neoplasms. For the lymphoid neoplasms, this classification provides a refinement of the entities described in the Revised European-American Lymphoma (REAL) Classification-a system that is now used worldwide. To date, however, there has been no published explanation or rationale given for the WHO classification of the myeloid neoplasms. The purpose of this communication is to outline briefly the WHO classification of malignant myeloid diseases, to draw attention to major differences between it and antecedent classification schemes, and to provide the rationale for those differences. ( IntroductionRecently, the World Health Organization (WHO), in conjunction with the Society for Hematopathology and the European Association of Hematopathology, published a new classification for hematopoietic and lymphoid neoplasms. 1 The concepts that underlie this classification were derived from numerous published clinical and scientific studies and from the experience of more than 100 pathologists, clinicians, and scientists from around the world who collaborated to develop this consensus classification. 2 A basic principle of the WHO system is that the classification of hematopoietic and lymphoid neoplasms should utilize not only morphologic findings but also all available information, including genetic, immunophenotypic, biologic, and clinical features to define specific disease entities. Essentially, the WHO classification attempts to incorporate those disease characteristics that have proved to have clinical and biologic relevance into a useful, working nomenclature.For the lymphoid neoplasms, the WHO classification provides refinement of the entities defined in the Revised EuropeanAmerican Lymphoma (REAL) Classification-a system that is now widely used by pathologists and clinicians. 3 The WHO classification of myeloid neoplasms includes many of the criteria of the French-American-British (FAB) Cooperative Group classifications of acute myeloid leukemia (AML) 4 and myelodysplastic syndromes (MDS) 5 as well as guidelines of the Polycythemia Vera Study Group (PVSG) for the chronic myeloproliferative diseases (CMPDs), 6,7 but there are some significant differences. The purpose of this communication is to outline briefly the WHO classification of the myeloid neoplasms, to draw attention to major differences between the WHO and previous classifications of these disorders, and to provide the rationale for these differences. In addition, we wish to address and clarify specific issues concerning the classification that have appeared both prior and subsequent to the publication of the WHO monograph. The WHO classification of the myeloid neop...

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Chronic Neutrophilic Leukemia: Description of a New Case with Karyotypic Abnormalities

Cited by 30 publications

References 6 publications

Chronic neutrophilic leukemia (CNL): a clinical, pathologic and cytogenetic study

Chronic neutrophilic leukemia (CNL): a clinical, pathologic and cytogenetic study

Chronic Neutrophilic Leukemia Associated with Monoclonal Gammopathy of Undetermined Significance

The World Health Organization (WHO) classification of the myeloid neoplasms

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