Deletion of chromosome 17 as a novel cytogenetic finding in chronic neutrophilic leukemia: A case report

Abstract

Chronic neutrophilic leukemia (CNL) is an infrequently encountered myeloproliferative disorder characterized by sustained neutrophilic leukocytosis, hepatosplenomegaly and the absence of the Philadelphia chromosome. This study presents a 60-year-old male patient with a diagnosis corresponding to the WHO classification criteria for CNL who was treated at the First Affiliated Hospital of Harbin Medical University (Harbin, China). Chromosome analysis of the patient's bone marrow cells showed 44, XY, -17, 17 in all 20 metaphase spreads. Homoharringtonine was used to control the patient's high white cell count for a short time, although after two weeks, the patient complained of left upper quadrant discomfort and his blood count showed a white blood cell count of 40.8x109/l. However, the patient continued to undergo maintenance therapy and was discharged in good clinical condition with hydroxyurea treatment for 31 months. Usually, patients with CNL have normal karyotypes and no specific cytogenetic abnormalities have been identified. To the best of the authors' knowledge, this is the first case in the literature of a patient exhibiting the deletion of chromosome 17 with CNL. We concluded that deleted of tumor suppressor genes located on 17p13.1, such as p53, may be associated with the development of CNL. Patients with CNL have a poor prognosis, although the present patient has exhibited a prolonged stable phase with oral chemotherapy drug treatment.