Chronic neutrophilic leukemia laboratory findings: Difference between revisions
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* It can be used after treatment to see if copies of the BCR-ABL gene are still present. | * 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. | * If copies of this gene are found it means that the [[leukemia]] is still present. | ||
==References== | ==References== | ||
Revision as of 15:25, 1 February 2019
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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]
- Mild anemia
- Thrombocytopenia
- Elevation of lactate dehydrogenase (LDH)
- Elevation of vitamin B12
Blood tests:
- Anemia
- Leukocytosis (median of 100,000/µL) with a left shift
- Thrombocytosis
- 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.
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.