Granulocyte-colony stimulating factor concentrations in a patient with plasma cell dyscrasia and clinical features of chronic neutrophilic leukaemia.

Monoclonal Gammopathy of Undetermined Significance Disguised as Chronic Neutrophilic Leukemia

“…In our case, one could postulate that the neutrophilia is related to the monoclonal gammopathy via an indirect stimulatory effect resulting in increased release of endogenous G-CSF. Studies have indeed shown the existence of high serum levels of G-CSF in patients with plasma cell neoplasm 5. Unfortunately, due to loss of follow-up, we were unable to obtain further blood samples from the patient to evaluate whether she had elevated serum cytokine levels of G-CSF or IL-6.…”

“…Proposed theories for this association include the expression of high levels of cytokines, such as IL-6, produced by plasma cells, which may result in proliferation of other myeloid clones,4 and overproduction of colony-stimulating growth factor (G-CSF), which may induce myeloid growth 5. In this report, we present a unique case of MGUS with leukemoid reaction disguised as CNL.…”

Chronic neutrophilic leukaemia

“…Some studies have established the polyclonal nature of neutrophils in these conditions 42. One study demonstrated reduction in G-CSF levels and peripheral blood neutrophil count in a patient with sustained neutrophilia and plasma cell dyscrasia after pulsed steroid therapy 43. While majority of the studies support that the neutrophilia associated with plasma cell dyscrasia is reactive process, cases of CNL coexisting with plasma cell neoplasms may indeed exist.…”

Elevated Granulocyte Colony-Stimulating Factor, Non-Infectious Leukocytosis and Fevers in a Patient with Multiple Myeloma

“…Our patient's clinical presentation was therefore not consistent with a diagnosis of CNL. In four of the reported cases of plasma cell dyscrasias, persistent leukocytosis has been attributed to increased serum concentrations of G-CSF [4][5][6][7] . In two cases, G-CSF protein was detected by immunohistochemical staining within atypical plasma cells 6,7 .…”