title: Chronic neutrophilic leukaemia and plasma cell-related neutrophilic leukaemoid reactions.
abstract: Many cases reported as 'chronic neutrophilic leukaemia' have had an associated plasma cell neoplasm. Recent evidence suggests that the great majority of such cases represent a neutrophilic leukaemoid reaction to the underlying multiple myeloma or monoclonal gammopathy of undetermined significance. We have analysed all accessible reported cases to clarify the likely diagnosis and to ascertain whether toxic granulation, Döhle bodies and an increased neutrophil alkaline phosphatase score were useful in making a distinction between chronic neutrophilic leukaemia and a neutrophilic leukaemoid reaction. We established that all these changes occur in both conditions. Toxic granulation and Döhle bodies are more consistently present in leukaemoid reactions but also occur quite frequently in chronic neutrophilic leukaemia. The neutrophil alkaline phosphatase score is increased in both conditions and is of no value in making a distinction.
authors.affiliation: Department of Haematology, Imperial College Healthcare NHS Trust and Centre for Haematology, St Mary's Hospital campus of Imperial College London, St Mary's Hospital, London, UK.
authors.forename: Barbara J
authors.initials: BJ
authors.lastname: Bain
authors.affiliation: Barts and the London School of Medicine and Dentistry, Queen Mary University of London, St Batholomew's Hospital, London, UK.
authors.forename: Shahzaib
authors.initials: S
authors.lastname: Ahmad
mesh_terms: D015550:Cell Degranulation; D005260:Female; D006801:Humans; D002479:Inclusion Bodies / Q000378:metabolism / Q000473:pathology; D015470:Leukemia, Myeloid, Acute / Q000175:diagnosis / Q000378:metabolism / Q000473:pathology; D015467:Leukemia, Neutrophilic, Chronic / Q000175:diagnosis / Q000378:metabolism / Q000473:pathology; D008297:Male; D008998:Monoclonal Gammopathy of Undetermined Significance / Q000175:diagnosis / Q000378:metabolism / Q000473:pathology; D009101:Multiple Myeloma / Q000175:diagnosis / Q000378:metabolism / Q000473:pathology; D016609:Neoplasms, Second Primary / Q000175:diagnosis / Q000378:metabolism / Q000473:pathology
keywords: chronic leukaemia; chronic neutrophilic leukaemia; monoclonal gammopathy of undetermined significance; multiple myeloma