Chronic Neutrophilic Leukemia

Abstract

A review of the literature was performed in an attempt to delineate the features of chronic neutrophilic leukemia (CNL). CNL is a very rare type of leukemia and only about 50 cases have been diagnosed with certainty in the literature. The diagnostic criteria of CNL are proposed, that is, 1) severe sustained mature neutrophilic leukocytosis (<20×10⁹/l ), 2) the absence of Ph¹ chromosome, 3) the absence of other chronic myeloproliferative disorders (polycythemia vera and essential thrombocythemia), 4) high neutrophilic alkaline phosphatase, and 5) the absence of a reactive leukemoid state. All these items have to be fulfilled for the diagnosis. Hepatosplenomegaly, Döhle bodies and toxic granules in neutrophils, elevated vitamin B₁₂, lysozyme and uric acid in the serum are virtually common findings, but not essential.
The coexistence of CNL and monoclonal gammopathy including myeloma appears substantial.