Chronic neutrophilic leukemia laboratory findings: Difference between revisions
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Some patients with CNL may have:<ref name="HasleOlesen1996">{{cite journal|last1=Hasle|first1=Henrik|last2=Olesen|first2=Gitte|last3=Kerndrup|first3=GITTE|last4=Philip|first4=Preben|last5=Jacobsen|first5=Niels|title=Chronic neutrophil leukaemia in adolescence and young adulthood|journal=British Journal of Haematology|volume=94|issue=4|year=1996|pages=628–630|issn=0007-1048|doi=10.1046/j.1365-2141.1996.7082329.x}}</ref><ref name="ElliottHanson2004">{{cite journal|last1=Elliott|first1=M A|last2=Hanson|first2=C A|last3=Dewald|first3=G W|last4=Smoley|first4=S A|last5=Lasho|first5=T L|last6=Tefferi|first6=A|title=WHO-defined chronic neutrophilic leukemia: a long-term analysis of 12 cases and a critical review of the literature|journal=Leukemia|volume=19|issue=2|year=2004|pages=313–317|issn=0887-6924|doi=10.1038/sj.leu.2403562}}</ref><ref name="Elliott2006">{{cite journal|last1=Elliott|first1=Michelle A.|title=Chronic neutrophilic leukemia and chronic myelomonocytic leukemia: WHO defined|journal=Best Practice & Research Clinical Haematology|volume=19|issue=3|year=2006|pages=571–593|issn=15216926|doi=10.1016/j.beha.2005.07.012}}</ref> | Some patients with CNL may have:<ref name="HasleOlesen1996">{{cite journal|last1=Hasle|first1=Henrik|last2=Olesen|first2=Gitte|last3=Kerndrup|first3=GITTE|last4=Philip|first4=Preben|last5=Jacobsen|first5=Niels|title=Chronic neutrophil leukaemia in adolescence and young adulthood|journal=British Journal of Haematology|volume=94|issue=4|year=1996|pages=628–630|issn=0007-1048|doi=10.1046/j.1365-2141.1996.7082329.x}}</ref><ref name="ElliottHanson2004">{{cite journal|last1=Elliott|first1=M A|last2=Hanson|first2=C A|last3=Dewald|first3=G W|last4=Smoley|first4=S A|last5=Lasho|first5=T L|last6=Tefferi|first6=A|title=WHO-defined chronic neutrophilic leukemia: a long-term analysis of 12 cases and a critical review of the literature|journal=Leukemia|volume=19|issue=2|year=2004|pages=313–317|issn=0887-6924|doi=10.1038/sj.leu.2403562}}</ref><ref name="Elliott2006">{{cite journal|last1=Elliott|first1=Michelle A.|title=Chronic neutrophilic leukemia and chronic myelomonocytic leukemia: WHO defined|journal=Best Practice & Research Clinical Haematology|volume=19|issue=3|year=2006|pages=571–593|issn=15216926|doi=10.1016/j.beha.2005.07.012}}</ref> | ||
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===== Bone marrow test: ===== | ===== Bone marrow test: ===== | ||
* | * | ||
* | *Hypercellularity of [[bone marrow]]. | ||
*[[Neutrophil granulocytes]] increased in percentage and number | |||
*Normal [[neutrophil]] [[maturation]] | |||
*[[Myeloblast|Myeloblasts]] <5% of [[nucleated]] cells | |||
*Presence of translocation between chromosomes 9 and 22. | *Presence of translocation between chromosomes 9 and 22. | ||
*Presence of BCR-ABL transcripts by RT-PCR. | *Presence of BCR-ABL transcripts by RT-PCR. | ||
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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]
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:
- Peripheral blood White blood cells (WBC) ≥25 ×109/L
- Segmented neutrophils plus band forms ≥80% of WBC
- Myeloblasts rarely observed
- Monocyte count <1 ×109/L
- Mild anemia
- Thrombocytopenia
Bone marrow test:
- Hypercellularity of bone marrow.
- Neutrophil granulocytes increased in percentage and number
- Normal neutrophil maturation
- Myeloblasts <5% of nucleated cells
- Presence of translocation between chromosomes 9 and 22.
- Presence of BCR-ABL transcripts by RT-PCR.
Blood chemistry tests:
- Elevation of lactate dehydrogenase (LDH).
Blood vitamin analysis:
- Evation of vitamin B12
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.
References
- ↑ 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.
- ↑ 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.
- ↑ 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.