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Chronic Neutrophilic Leukaemia

Chronic Neutrophilic Leukaemia I read with interest the case report of Zhang et al. [1] of a JAK2 V617F mutation in chronic neutrophilic leukaemia (CNL). However, I should like to suggest that an alternative diagnosis be considered. The platelet count was 628 × 109/l with no description of megakaryocyte morphology being given. Following the 2008 WHO criteria for a diagnosis of CNL, it is required that there be ‘no evidence of essential thrombocythaemia' [2]. This platelet count meets the WHO criteria for a diagnosis of essential thrombocythaemia, and in that condition the JAK2 mutation would not be at all surprising. Admittedly, the WHO authors also state that in essential thrombocythaemia the white cell count is usually normal, although a borderline elevation may occur [3]. The situation is not straightforward, but the case appears closer to essential thrombocythaemia than to CNL. In addition, the possibility of prefibrotic myelofibrosis should also be considered when assessing the trephine biopsy sections. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Acta Haematologica Karger

Chronic Neutrophilic Leukaemia

Acta Haematologica , Volume 131 (1): 1 – Jan 1, 2013

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References (1)

Publisher
Karger
Copyright
© 2013 S. Karger AG, Basel
ISSN
0001-5792
eISSN
1421-9662
DOI
10.1159/000354823
Publisher site
See Article on Publisher Site

Abstract

I read with interest the case report of Zhang et al. [1] of a JAK2 V617F mutation in chronic neutrophilic leukaemia (CNL). However, I should like to suggest that an alternative diagnosis be considered. The platelet count was 628 × 109/l with no description of megakaryocyte morphology being given. Following the 2008 WHO criteria for a diagnosis of CNL, it is required that there be ‘no evidence of essential thrombocythaemia' [2]. This platelet count meets the WHO criteria for a diagnosis of essential thrombocythaemia, and in that condition the JAK2 mutation would not be at all surprising. Admittedly, the WHO authors also state that in essential thrombocythaemia the white cell count is usually normal, although a borderline elevation may occur [3]. The situation is not straightforward, but the case appears closer to essential thrombocythaemia than to CNL. In addition, the possibility of prefibrotic myelofibrosis should also be considered when assessing the trephine biopsy sections.

Journal

Acta HaematologicaKarger

Published: Jan 1, 2013

Keywords: Chronic leukemia

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