Chronic neutrophilic leukemia natural history, compilications and prognosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Homa Najafi, M.D.[2]; Grammar Reviewer: Natalie Harpenau, B.S.[3]
Overview
Course of the disease is variable in CNL patients, developing blast crisis is happened in most patients. Moreover, Progression to acute myeloid leukemia may seen in 10-21.2% of patients with CNL. Common complications of CNL include predisposing to hemorrhage, progression of disease, blastic or leukemic conversion and treatment-related toxicity .Prognosis is generally poor, and the 5-year survival rate of patients with CNL is approximately 28%. Some criteria same as treatment resistance, refractory neutrophilia, increasing in red blood cells, platelet transfusion dependency, deterioration of organomegaly and blast crisis indicate disease progression.
Natural History, Complications, and Prognosis
Natural History
- Course of the disease is variable in CNL patients, developing blast crisis is happened in most patients. Moreover, Progression to acute myeloid leukemia may seen in 10-21.2% of patients with CNL.[1][2][3]
Complications
- The common complications of CNL include:[4][5]
- Predisposing to hemorrhage (intracranial hemorrhage as the most common cause of death in CNL patients)
- Progression of disease
- Blastic or leukemic conversion
- Treatment-related toxicity
Prognosis
- Prognosis is generally poor, and the 5-year survival rate of patients with CNL is approximately 28%.[3][6]
- The factors that can predict poor outcomes are:[1][7][8]
- White blood cell count > 50,000 cells per microliter
- ASXL1 mutation
- Thrombocytopenia
- Advanced age
- Dependency to transfusion
- Peripheral blasts ≥ 1%
- Marrow blasts ≥ 10%
- Splenomegaly
- The evidence of disease progression in CNL patients include:[9]
- Treatment-resistant
- Refractory neutrophilia
- Increasing in red blood cells
- Platelet transfusion dependency
- Deterioration of organomegaly
- Blast crisis
References
- ↑ 1.0 1.1 Dao, Kim-Hien T.; Tyner, Jeffrey W.; Gotlib, Jason (2017). "Recent Progress in Chronic Neutrophilic Leukemia and Atypical Chronic Myeloid Leukemia". Current Hematologic Malignancy Reports. 12 (5): 432–441. doi:10.1007/s11899-017-0413-y. ISSN 1558-8211.
- ↑ Elliott, Michelle A. (2006). "Chronic neutrophilic leukemia and chronic myelomonocytic leukemia: WHO defined". Best Practice & Research Clinical Haematology. 19 (3): 571–593. doi:10.1016/j.beha.2005.07.012. ISSN 1521-6926.
- ↑ 3.0 3.1 Reilly, John T. (2002). "CHRONIC NEUTROPHILIC LEUKAEMIA: A DISTINCT CLINICAL ENTITY?". British Journal of Haematology. 116 (1): 10–18. doi:10.1046/j.1365-2141.2002.03234.x. ISSN 0007-1048.
- ↑ Elliott, M A; Hanson, C A; Dewald, G W; Smoley, S A; Lasho, T L; Tefferi, A (2004). "WHO-defined chronic neutrophilic leukemia: a long-term analysis of 12 cases and a critical review of the literature". Leukemia. 19 (2): 313–317. doi:10.1038/sj.leu.2403562. ISSN 0887-6924.
- ↑ Cigudosa, Juan C; Menezes, Juliane (2015). "Chronic neutrophilic leukemia: a clinical perspective". OncoTargets and Therapy: 2383. doi:10.2147/OTT.S49688. ISSN 1178-6930.
- ↑ J. Bohm & H. E. Schaefer (2002). "Chronic neutrophilic leukaemia: 14 new cases of an uncommon myeloproliferative disease". Journal of clinical pathology. 55 (11): 862–864. PMID 12401827. Unknown parameter
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ignored (help) - ↑ Elliott, Michelle A.; Pardanani, Animesh; Hanson, Curtis A.; Lasho, Terra L.; Finke, Christy M.; Belachew, Alem A.; Tefferi, Ayalew (2015). "ASXL1mutations are frequent and prognostically detrimental inCSF3R-mutated chronic neutrophilic leukemia". American Journal of Hematology. 90 (7): 653–656. doi:10.1002/ajh.24031. ISSN 0361-8609.
- ↑ Massimo Breccia, Francesca Biondo, Roberto Latagliata, Ida Carmosino, Franco Mandelli & Giuliana Alimena (2006). "Identification of risk factors in atypical chronic myeloid leukemia". Haematologica. 91 (11): 1566–1568. PMID 17043019. Unknown parameter
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ignored (help) - ↑ Dao, K.-H. T.; Tyner, J. W. (2015). "What's different about atypical CML and chronic neutrophilic leukemia?". Hematology. 2015 (1): 264–271. doi:10.1182/asheducation-2015.1.264. ISSN 1520-4391.