Chronic neutrophilic leukemia laboratory findings: Difference between revisions

Jump to navigation Jump to search
VisualWikitext
No edit summary
Line 16: Line 16:
*Elevation of [[lactate dehydrogenase]] (LDH)
*Elevation of [[lactate dehydrogenase]] (LDH)
*Elevation of [[vitamin B12]]
*Elevation of [[vitamin B12]]
===== '''Blood tests:''' =====
*[[Anemia]]
*[[Leukocytosis]] (median of 100,000/µL) with a [[left shift]]
*[[Thrombocytosis]]
*[[Blast|Blasts]] usually number <2%
*Absolute [[basophilia]] is nearly universal
*Absolute [[eosinophilia]]
*[[Monocytosis]]
*[[Thrombocytosis]]
*[[Thrombocytopenia]] suggests an alternative diagnosis or the presence of advanced stage
*Elevated [[uric acid]]
*Elevated [[histamine]] levels due to [[basophilia]]
==== '''Differential blood test:''' ====
* A differential (diff), which is a count of the different types of white blood cells in a peripheral blood sample.
==='''Peripheral  blood smear:'''===
*Increase in immature myeloid cells at various stage of maturation (i.e. myelocytes and band cells).
===== Bone marrow test: =====
*Increase in immature myeloid cells at various stage of maturation (i.e. myelocytes and band cells).
*Presence of translocation between chromosomes 9 and 22.
*Presence of BCR-ABL transcripts by RT-PCR.
==== Blood chemistry tests: ====
*Increased creatinine in some cases.
*Increased liver enzymes in some cases.
==== Conventional cytogenetics and karyotyping: ====
* This test looks at chromosomes under a microscope.
* The chromosomes can best be seen when the cell is dividing, so a sample of [[blood]] or [[bone marrow]] must be grown ''in vitro'' so that the cells start to divide.
* The leukemia cells in all [[CML]] patients contain an abnormal [[chromosome]] called the [[Philadelphia (Ph) chromosome]], which looks like a shortened version of chromosome 22.
==== Fluorescent in situ hybridization (FISH): ====
* FISH is another way to look at chromosomes and is more precise than conventional cytogenetics because it uses fluorescent dyes that only attach to specific genes or parts of [[chromosomes]].
* In [[CML]], FISH can be used to look for specific pieces of the BCR-ABL [[gene]] on chromosomes.
==== Polymerase chain reaction (PCR): ====
* This is a highly sensitive test that can be used to look for the BCR-ABL product in [[leukemia]] cells. PCR is useful for quantitation.
* It can be done on blood or bone marrow samples and can detect very small amounts of BCR-ABL, even when Philadelphia chromosome can not be detected with cytogenetic testing.
* It can be used after treatment to see if copies of the BCR-ABL gene are still present.
* If copies of this gene are found it means that the [[leukemia]] is still present.
<gallery widths="200px" class="center">
Leukemia-flurescent.jpg| A photomicrograph of leukemia cells using Direct Fluorescent Antibody staining technique (DFA).<ref name="cdc">Center for Disease Control and Prevention. Public Health Image Library 2015.http://phil.cdc.gov/phil/details.asp</ref>
</gallery>


==References==
==References==

Revision as of 15:15, 1 February 2019

Chronic neutrophilic leukemia Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Epidemiology and Demographics

Risk Factors

Screening

Differentiating Chronic neutrophilic leukemia from other Diseases

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X Ray

CT scan

MRI

Echocardiography and Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Interventions

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Chronic neutrophilic leukemia laboratory findings On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Chronic neutrophilic leukemia laboratory findings

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Chronic neutrophilic leukemia laboratory findings

CDC on Chronic neutrophilic leukemia laboratory findings

Chronic neutrophilic leukemia laboratory findings in the news

Blogs on Chronic neutrophilic leukemia laboratory findings

Directions to Hospitals Treating Chronic neutrophilic leukemia

Risk calculators and risk factors for Chronic neutrophilic leukemia laboratory findings

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Homa Najafi, M.D.[2]

Overview

Laboratory findings consistent with the diagnosis of chronic neutrophilic leukemia (CNL) include chronic neutrophilia. Mild anemia, thrombocytopenia, elevation of lactate dehydrogenase and vitamin B12.

Laboratory Findings

A chronic elevated concentration of blood mature neutrophils is diagnostic for CNL.[1]

Some patients with CNL may have:[2][1][3]

Blood tests:

Differential blood test:

  • A differential (diff), which is a count of the different types of white blood cells in a peripheral blood sample.

Peripheral blood smear:

  • Increase in immature myeloid cells at various stage of maturation (i.e. myelocytes and band cells).
Bone marrow test:
  • Increase in immature myeloid cells at various stage of maturation (i.e. myelocytes and band cells).
  • Presence of translocation between chromosomes 9 and 22.
  • Presence of BCR-ABL transcripts by RT-PCR.

Blood chemistry tests:

  • Increased creatinine in some cases.
  • Increased liver enzymes in some cases.

Conventional cytogenetics and karyotyping:

  • This test looks at chromosomes under a microscope.
  • The chromosomes can best be seen when the cell is dividing, so a sample of blood or bone marrow must be grown in vitro so that the cells start to divide.
  • The leukemia cells in all CML patients contain an abnormal chromosome called the Philadelphia (Ph) chromosome, which looks like a shortened version of chromosome 22.

Fluorescent in situ hybridization (FISH):

  • FISH is another way to look at chromosomes and is more precise than conventional cytogenetics because it uses fluorescent dyes that only attach to specific genes or parts of chromosomes.
  • In CML, FISH can be used to look for specific pieces of the BCR-ABL gene on chromosomes.

Polymerase chain reaction (PCR):

  • This is a highly sensitive test that can be used to look for the BCR-ABL product in leukemia cells. PCR is useful for quantitation.
  • It can be done on blood or bone marrow samples and can detect very small amounts of BCR-ABL, even when Philadelphia chromosome can not be detected with cytogenetic testing.
  • It can be used after treatment to see if copies of the BCR-ABL gene are still present.
  • If copies of this gene are found it means that the leukemia is still present.
  • A photomicrograph of leukemia cells using Direct Fluorescent Antibody staining technique (DFA).[4]

    A photomicrograph of leukemia cells using Direct Fluorescent Antibody staining technique (DFA).[4]

References

  1. ↑ 1.0 1.1 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.
  2. ↑ Hasle, Henrik; Olesen, Gitte; Kerndrup, GITTE; Philip, Preben; Jacobsen, Niels (1996). "Chronic neutrophil leukaemia in adolescence and young adulthood". British Journal of Haematology. 94 (4): 628–630. doi:10.1046/j.1365-2141.1996.7082329.x. ISSN 0007-1048.
  3. ↑ 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.
  4. ↑ Center for Disease Control and Prevention. Public Health Image Library 2015.http://phil.cdc.gov/phil/details.asp

Template:WH Template:WS

Retrieved from "https://www.wikidoc.org/index.php?title=Chronic_neutrophilic_leukemia_laboratory_findings&oldid=1544574"