Yassin Mohamed A, Kohla Samah, Al-Sabbagh Ahmed, Soliman Ashraf T, Yousif Anil, Moustafa Afraa, Battah Afaf Al, Nashwan Abdulqadir, Al-Dewik Nader
Department of Hematology and Bone Marrow Transplant, National Center for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar.
Department of Laboratory Medicine and Pathology, Hamad Medical Corporation, Doha, Qatar.
Clin Med Insights Case Rep. 2015 Apr 19;8:33-6. doi: 10.4137/CCRep.S22820. eCollection 2015.
Chronic neutrophilic leukemia (CNL) is a rare myeloproliferative neoplasm (MPN) that represents a diagnostic dilemma for both clinicians and pathologists. Because this disease entity is very rare, and because its diagnosis is by exclusion, it is important for clinical hematologists and hematopathologists to be familiar with CNL when approaching patients with MPNs and persistent neutrophilia. A woman in her 40s who was incidentally found to have leukocytosis was referred to the hematology service at the National Center for Cancer Care and Research for evaluation. Complete blood count revealed hyperleukocytosis with predominant neutrophilia. Peripheral blood and flow cytometry did not show any evidence of lymphoproliferative disorder or myeloblasts. Bone marrow aspirate and biopsy revealed a hypercellular marrow with myeloid hyperplasia. Cytogenetics revealed normal karyotype. Tests for both Janus kinase mutation JAK2 V617F and rearrangement of the genes BCR-ABL1, platelet-derived growth factor receptor-α (PDGFRα), PDGFRβ, and fibroblast growth factor receptor-1 (FGFR1) were negative. Thereafter, the diagnosis of CNL was reached. She was treated with pegylated interferon alpha-2a, with very good hematological response. To the best of our knowledge, this is the first case of CNL reported among the Arab population.
慢性中性粒细胞白血病（CNL）是一种罕见的骨髓增殖性肿瘤（MPN），对临床医生和病理学家来说都是一个诊断难题。由于这种疾病实体非常罕见，且其诊断是通过排除法，因此临床血液学家和血液病理学家在面对患有MPN和持续性中性粒细胞增多的患者时熟悉CNL很重要。一名40多岁的女性偶然发现白细胞增多，被转诊至国家癌症治疗与研究中心的血液科进行评估。全血细胞计数显示白细胞增多，以中性粒细胞增多为主。外周血和流式细胞术未显示任何淋巴增殖性疾病或原始粒细胞的证据。骨髓穿刺和活检显示骨髓细胞增多伴髓系增生。细胞遗传学显示核型正常。Janus激酶突变JAK2 V617F以及BCR-ABL1、血小板衍生生长因子受体-α（PDGFRα）、PDGFRβ和成纤维细胞生长因子受体-1（FGFR1）基因重排的检测均为阴性。此后，确诊为CNL。她接受了聚乙二醇化干扰素α-2a治疗，血液学反应非常好。据我们所知，这是阿拉伯人群中报道的首例CNL病例。
