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Chronic neutrophilic leukemia--a case report
C S Chang1, S F Lin, S M Hwang
1Division of Hemato-oncology, Kaohsiung Medical College, Taiwan, Republic of China.
Gaoxiong Yi Xue Ke Xue Za Zhi = the Kaohsiung Journal of Medical Sciences
|March 1, 1995
Summary
This case study details a 77-year-old with chronic neutrophilic leukemia (CNL), successfully treated with hydroxyurea. The patient showed impaired neutrophil function despite normalized counts, highlighting CNL complexities.
Area of Science:
- Hematology
- Oncology
- Internal Medicine
Background:
- Chronic neutrophilic leukemia (CNL) is a rare myeloproliferative neoplasm.
- Characterized by sustained neutrophilia without an identifiable cause.
- Often presents with splenomegaly and elevated serum vitamin B12.
Observation:
- A 77-year-old patient presented with symptoms consistent with CNL.
- Diagnosis confirmed by marked increase in mature neutrophils, splenomegaly, elevated B12, and exclusion of infection/malignancy.
- Chromosome analysis revealed one abnormal karyotype in 14 metaphases.
Findings:
- Neutrophilic function tests (nitroblue tetrazolium) indicated impaired phagocytosis.
- Hydroxyurea treatment normalized neutrophil counts.
- A high percentage of mature neutrophils persisted post-treatment.
Implications:
- This case highlights the diagnostic criteria for CNL.
- Demonstrates hydroxyurea's efficacy in managing neutrophilia in CNL.
- Suggests persistent mature neutrophil percentage may be a feature of CNL prognosis.