Chronic Neutrophilic Leukemia

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Abstract
An interesting patient with clinical features resembling chronic myelogenous leukemia is described. The patient''s leucocytosis was persistent and was made up almost entirely of mature polymorphonuclear neutrophils. The bone marrow revealed active mye-loid proliferation, a moderate increase in immature myeloid cells, and an orderly progression of maturation of these cells. Bone marrow fibrosis was minimal. Serum levels of vitamin B12 were markedly elevated. Hyperuricemia and attacks of gouty arthritis were prominent features of his illness. The very high leucocyte alkaline phosphatase activity and the absence of the Philadelphia chromosome in the peripheral blood and bone marrow distinguished this patient from patients with chronic myelogenous leukemia. The constellation of findings in this patient and in some rare cases previously described would seem to justify a designation of chronic neutrophilic leukemia. Such cases constitute another clinical entity within the broad category of myelopro-liferative diseases.