Elevated neutrophil function in chronic neutrophilic leukemia

Abstract

A 65-year-old man with marked leukocytosis was admitted for diagnosis and treatment. His peripheral blood leukocyte count was 37,500/microliters and the leukocytes consisted of mature neutrophil-like cells. A high neutrophil alkaline phosphatase score and a normal bone marrow cell karyotype suggested that the patient had chronic neutrophilic leukemia rather than chronic myeloid leukemia. Several neutrophil functions, such as superoxide production, nitroblue tetrazolium reduction activity, and phagocytosis, were elevated. These data and the morphological features (toxic granules and Döhle bodies) indicated that the patient's neutrophils were in an activated stage.

Chronic neutrophilic leukemia 2016: Update on diagnosis, molecular genetics, prognosis, and management

“…At that time, only 150 cases had been reported in the literature [29,31,32]. A critical review of the literature applying the then recently developed WHO diagnostic criteria, could only confirm this diagnosis in 40 cases, indicating the true rate of occurrence of what is now considered CNL was even lower [5,[32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47]. In this data set of WHO-defined CNL, the median age at diagnosis was 66 years (range: 15 -86) and 56% were males [5].…”

Chronic neutrophilic leukaemia

“…Segmented neutrophils and bands comprise >80% of the total white cells 7. Neutrophils frequently show toxic granulations and Döhle bodies, which suggests an activated state 17. Features of dysplasia are usually absent.…”

Bleeding tendency in chronic neutrophilic leukemia

“…Unfortunately, platelet function was not evaluated in any of the 40 patients [9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25]. Qualitative platelet abnormalities are commonly found in patients with myeloproliferative disorders (MPDs) such as chronic myelogenous leukemia, myeloid metaplasia and myelofibrosis, polycythemia vera, and essential thrombocythemia [26,27].…”