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Atlas of Bone Marrow pathology
Mojmir Moulis, Josef Feit et al.
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Chronic Neutrophilic Leukemia (CNL)
Introduction

A rare disorder characterised by neutrophilia in peripheral blood and expansion of neutrophilic granulopoiesis. The BCR-ABL1 fusion gene is absent as well as other reactive causes and MPNs.

Etiology

90% of all cases show a normal genetic prophile, BCR-ABL1 is absent, however JAK 2 mutation may occasionally occure.

Clinical signs
  • splenomegaly, which may be symptomatic
  • usually hepatomegaly
  • asi ve 25 – 30% cutaneous and mucous haemorrhage, especially in the GIT
  • prognosis: survival time varies from 6 months to 20 years, sometimes transformation into AML
Histology

Hypercellular bone marrow with predominant neutrophilic granulopoiesis (M:E is 20:1 or more), the number of myeloblasts and promyelocytes is not increased, myelocytes and mature neutrophils predominate. Erythroid and megakaryocytic preliferation may occur. Significant dysplastic changes are absent.