Chronic neutrophilic leukemia associated with chronic lymphocytic leukemia

• Published in: International journal of hematology Vol. 68; no. 1; p. 87
• Main Authors: Ito, K, Usuki, K, Iki, S, Urabe, A
• Format: Journal Article
• Language: English
• Published: Japan 01.07.1998
• Subjects: Aged; Aged, 80 and over; B-Lymphocytes - pathology; Humans; Leukemia, Lymphocytic, Chronic, B-Cell - complications; Leukemia, Lymphocytic, Chronic, B-Cell - genetics; Leukemia, Lymphocytic, Chronic, B-Cell - pathology; Leukemia, Neutrophilic, Chronic - complications; Leukemia, Neutrophilic, Chronic - genetics; Leukemia, Neutrophilic, Chronic - pathology; Male
• ISSN: 0925-5710
• DOI: 10.1016/s0925-5710(98)00031-0

We report on an 83-year-old male with chronic neutrophilic leukemia (CNL) associated initially with IgM monoclonal gammopathy and later with B cell chronic lymphocytic leukemia (CLL), in which the clone differed from that of the preceding monoclonal gammopathy. At initial presentation, the patient had hepatosplenomegaly, leukocytosis (29100 x 10(6)/l) with an increase of mature neutrophils (83%), 20q- chromosomal abnormality, an increased leukocyte alkaline phosphatase score, elevated serum levels of vitamin B12 and uric acid, a low serum level of granulocyte colony-stimulating factor, and high serum IgM (1015 mg/dl: lambda type M protein). Thereafter, lymphocytosis developed gradually. Three years after the initial presentation, the patient had no serum M protein, but showed evidence of leukocytosis (36600 x 10(6)/l) with 20q- chromosomal abnormality and an increase of mature neutrophils (51%) and small lymphocytes (43.5%), CD5+/19+/20+/HLA-DR+ and surface membrane IgM+/D+/kappa+. Gene rearrangements of the immunoglobulin heavy and kappa light chains were also present. To our knowledge, this is the first reported case of CNL associated with CLL.