Allogeneic bone marrow transplantation in the management of chronic neutrophilic leukemia

Chronic neutrophilic leukemia (CNL) is a rare myeloproliferative disorder characterized by a clonal proliferation of mainly mature neutrophils, which is often difficult to differentiate from reactive leukocytosis or other myeloproliferative disorders. Treatment to date has focused on disease control rather than cure. Once the disease has progressed to a more aggressive leukemia there is typically little chance of obtaining a long lasting remission due to the older age of most patients as well as the acquisition of multiple poor prognostic cytogenetic abnormalities. In this case report we describe a successful sibling allogeneic bone marrow transplant in a 60-year-old man with CNL performed while he was still in the stable phase of his disease. We propose that even in older patients this curative approach may be considered in selected patients at an early stage of their disease, similar to the approach taken with chronic myelogenous leukemia.