Chronic neutrophilic leukemia diagnostic study of choice

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

Overview

World health organization (WHO) introduces criteria for the diagnosis of chronic neutrophilic leukemia (CNL) that are based on the laboratory finding of peripheral blood cells, bone marrow, cytogenic mutation, and differential diagnosis.

The diagnosis of CNL is based on the WHO criteria, which include:^[1]

World Health Organization (WHO) Criteria for CNL diagnosis
1. Peripheral blood White blood cells (WBC) ≥25 × 109/L:	Segmented neutrophils plus band forms ≥80% of WBC Neutrophil precursors <10% of WBC Myeloblasts rarely observed Monocyte count <1 × 109/L No dysgranulopoies.
2. Hypercellular bone marrow:	Neutrophil granulocytes increased in percentage and number Normal neutrophil maturation Myeloblasts <5% of nucleated cells
3. Not meeting WHO criteria for:	BCR-ABL1+ chronic myeloid leukemia, Polycythemia vera Essential thrombocythemia Primary myelofibrosis
4. No rearrangement of:	PDGFRA PDGFRB FGFR1 PCM1-JAK2
5.Presence of CSF3RT618I or other activating CSF3R mutation or In the absence of a CSFR3R mutation, persistent neutrophilia (at least 3 months), splenomegaly, and no identifiable cause of reactive neutrophilia including the absence of a plasma cell neoplasm or, if present, demonstration of clonality of myeloid cells by cytogenetic or molecular studies.

↑ Arber, D. A.; Orazi, A.; Hasserjian, R.; Thiele, J.; Borowitz, M. J.; Le Beau, M. M.; Bloomfield, C. D.; Cazzola, M.; Vardiman, J. W. (2016). "The 2016 revision to the World Health Organization classification of myeloid neoplasms and acute leukemia". Blood. 127 (20): 2391–2405. doi:10.1182/blood-2016-03-643544. ISSN 0006-4971.