Chronic neutrophilic leukemia is characterized by leukocytosis with mature neutrophil
in peripheral blood, the absence of Ph' chromosome, and elevated neutrophil alkaline
phosphatase activity.
We have experienced a 63 fears old male Patient of typical chronic neutrophilic
leukemia who complained of splenomegaly and liver disease. On admission, peripheral
blood examination showed leukocytosis with mature neutrophil: Hgb 16.4 g/100㎖, WBC
30,400/㎣, Platelet 200,000/㎣ and neutrophils 75% in differential count. Rare immature
neutrophils, high level of neutrophil alkaline phosphatase and toxic granulation in their
cytoplasm were observed in the smear of peripheral blood. Bone marrow studs revealed
hypercellular marrow with prominent neutrophilic hyperplasia and without myelofibrosis.
Cytogenetic study showed no Ph' chromosome in 2 days culture of non-stimulated bone
marrow cells. On hemopoietic cell culture (CFU-GM) of marrow cells, GM colony
formation was reduced and morphological abnormalities were not recognized at 7 day
culture. Since 5 years ago, when this patient was recognized as disease entity of chronic
neutrophilic leukemia, the underlying discase which causes a leukemoid reaction has not
been detected.
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