Chronic Myelogenous Leukemia with Elevated Leukocyte Alkaline Phosphatase, Positive Indirect Coombs’ Test, Neutrophilic Leukocytosis and Unusual Cytogenetical Findings

Abstract

An unusual case of chronic myelogenous leukemia (CML) is reported, which was characterized by leukocytosis without a shift to the left, elevated leukocyte alkaline phosphatase, positive indirect Coombs’ test, anemia and thrombocytosis, as well as the absence of hepatosplenomegaly. The diagnosis of CML was ascertained by the presence of Philadelphia chromosome with translocation of its deleted arms on the short arms of a chromosome No. 6. The possible relationship between the chromosomal aberration and the unusual hematological and clinical features of this case is discussed.

Chronic Granulocytic Leukaemia with a raised Leukocyte Alkaline Phosphatase Score

“…Like their patient, she had a thrombocytosis. None of the intercurrent conditions quoted by Grinblat et al 3 as being associated with chronic granulocytic leukaemia and a raised LAP score were present in this patient.…”

Chronic Neutrophilic Leukemia: A Comprehensive Review of Clinical Characteristics, Genetic Landscape and Management

“…The enzymatic equipment of neutrophils is normal, as this can be revealed by the appropriate cytochemical stains. Myeloperoxidase is strongly positive as is also LAP, whose elevated score has been used to distinguish this disease from BCR/ABL positive CML, in which LAP is very low to completely absent ( 6 , 7 , 11 , 12 ). Some studies have reported reduced lysozyme and β-glycuronidase content in the neutrophils ( 8 , 37 ) but these enzymes are highly released from clonal neutrophils, following stimulation.…”