Chronic Myeloid Neoplasms
Myeloproliferative neoplasms (MPN)
Chronic neutrophilic leukemia

Author: Nikhil Sangle, M.D. (see Authors page)

Revised: 6 March 2017, last major update August 2011

Copyright: (c) 2002-2017, PathologyOutlines.com, Inc.

PubMed Search: Chronic neutrophilic leukemia [title]

Cite this page: Chronic neutrophilic leukemia. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/myeloproliferativeCNL.html. Accessed November 21st, 2017.
Definition / general

Bone marrow:
  • Hypercellular with granulocyte hyperplasia, predominantly segmented and band neutrophils
  • Variable erythroid and megakaryocyte hyperplasia; no/minimal dysplastic changes
  • No increased myeloblasts
Diagnosis
WHO 2008:
  • ≥ 25 × 109 WBC in peripheral blood, with > 80% segmented neutrophils or bands, < 10% immature granulocytes and < 1% myeloblasts ( < 5% blasts in the bone marrow)
  • No cause for reactive neutrophilia
  • Demonstration of clonal status of the granulocytes
  • Hepatosplenomegaly
  • No rearrangement of PDGFRA, PDGFRB or FGFR1
  • No BCR-ABL
  • No dyserythropoiesis, no granulocyte dysplasia, no monocytosis
  • No other myeloproliferative disorder (Ann Hematol 2008;87:1)
Laboratory
  • Increased WBC count > 25 × 109/L with neutrophilia, increased serum vitamin B12
Case reports
Treatment
  • Optimal treatment unknown
Microscopic (histologic) description
  • Bone marrow: hypercellular with granulocyte hyperplasia, predominantly segmented and band neutrophils; variable erythroid and megakaryocyte hyperplasia; no / minimal dysplastic changes; no increased myeloblasts
Microscopic (histologic) images

Images hosted on other servers:

Bone marrow smear:

Neutrophils at various maturational states



Nature images:

Peripheral blood:

Neutrophilia without left shift



Bone marrow biopsy:

Marked granulocytic proliferation

Molecular / cytogenetics description
Molecular:
Cytogenetics
  • 90% normal, also +8, 20q-
Differential diagnosis
  • CML with p230 variant BCR-ABL fusion transcript and mature peripheral blood neutrophils should be considered as CML (Cancer 2002;94:2416)
  • Myeloma or other neoplasms that secrete G-CSF or other cytokines may be associated with chronic neutrophilic leukemia but must demonstrate clonal granulocytes to establish the diagnosis (Am J Hematol 2005;80:243)