Re: Asthma / allergies / erythrocytosis / increased red blood cells
Think of a tachometer of your car .. the red line .. is ..
leukemia .. death ..
Korean J Intern Med. 2004 Dec;19(4):285-8. Related
Articles, Links
A case of transition of polycythemia vera to chronic
neutrophilic leukemia.
Lee SS, Moon JH, Ha JW, Lee YK, Ahn JS, Zang DY, Kim HJ.
Department of Internal Medicine, College of Medicine, Hallym
University, Sacred Heart Hospital, Anyang, Korea.
Chronic Neutrophilic Leukemia (CNL) is a rare
myeloproliferative disorder characterized by a persistent
increase of mature peripheral neutrophils, myeloid hyperplasia
in bone marrow, hepatosplenomegaly, elevated neutrophil
alkaline phosphatase (NAP) and absence of Philadelphia
chromosome, with no evidence of infection or malignancy
sufficient to mimic a leukemoid reaction. CNL has been
associated with multiple myelomas in many reported cases, but
transition of Polycythemia Vera (PV) to CNL is very rare. An
81-year-old female patient, who had undergone intermittent
phlebotomy following the diagnosis of PV 8 years previously,
was admitted to our hospital due to lower back pain. A
physical examination showed a splenomegaly 2 cm below the
costal margin, with tenderness of the thoracic and lumbar
spine area. A peripheral blood examination showed a WBC count
of 91,800/microL (neutrophil 88%) with a rare immature form,
hemoglobin of
9.1 g/dL and a platelet count of 1,661,000/microL. Her
NAP score was
10. The bone marrow examination showed 95% cellularity, with
an M:E ratio of 10:1, increased megakaryocytes with normal
morphology and the absence of myelofibrosis. Chromosomal
studies showed no Philadelphia chromosome. A radiological
examination showed compression fractures of the vertebrae
and spinal cord compression. No underlying disease causing
a leukemoid reaction was detected. With iron replacement,
the hemoglobin level failed to increase over 12 g/dL.
Therefore, it was concluded to be a transition of PV to
CNL. After administration of hydroxyurea and
vertebroplasty, the symptom improved and the WBC count was
sustained below 40,000/microL.
Publication Types: Case Reports
PMID: 15683121 [PubMed - indexed for MEDLINE]
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