Chronic neutrophilic leukemia medical therapy: Difference between revisions

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* Preffered ones:
* Preffered ones:
**1. [[Hydroxyurea]]:<ref name="ElliottHanson2004">{{cite journal|last1=Elliott|first1=M A|last2=Hanson|first2=C A|last3=Dewald|first3=G W|last4=Smoley|first4=S A|last5=Lasho|first5=T L|last6=Tefferi|first6=A|title=WHO-defined chronic neutrophilic leukemia: a long-term analysis of 12 cases and a critical review of the literature|journal=Leukemia|volume=19|issue=2|year=2004|pages=313–317|issn=0887-6924|doi=10.1038/sj.leu.2403562}}</ref><ref name="ElliottPardanani2015">{{cite journal|last1=Elliott|first1=Michelle A.|last2=Pardanani|first2=Animesh|last3=Hanson|first3=Curtis A.|last4=Lasho|first4=Terra L.|last5=Finke|first5=Christy M.|last6=Belachew|first6=Alem A.|last7=Tefferi|first7=Ayalew|title=ASXL1mutations are frequent and prognostically detrimental inCSF3R-mutated chronic neutrophilic leukemia|journal=American Journal of Hematology|volume=90|issue=7|year=2015|pages=653–656|issn=03618609|doi=10.1002/ajh.24031}}</ref><ref>{{cite web|url=http://packageinserts.bms.com/pi/pi_hydrea.pdf|title=Hydrea (Hydroxyurea Package Insert)}}</ref>
**1. [[Hydroxyurea]]:<ref name="ElliottHanson2004">{{cite journal|last1=Elliott|first1=M A|last2=Hanson|first2=C A|last3=Dewald|first3=G W|last4=Smoley|first4=S A|last5=Lasho|first5=T L|last6=Tefferi|first6=A|title=WHO-defined chronic neutrophilic leukemia: a long-term analysis of 12 cases and a critical review of the literature|journal=Leukemia|volume=19|issue=2|year=2004|pages=313–317|issn=0887-6924|doi=10.1038/sj.leu.2403562}}</ref><ref name="ElliottPardanani2015">{{cite journal|last1=Elliott|first1=Michelle A.|last2=Pardanani|first2=Animesh|last3=Hanson|first3=Curtis A.|last4=Lasho|first4=Terra L.|last5=Finke|first5=Christy M.|last6=Belachew|first6=Alem A.|last7=Tefferi|first7=Ayalew|title=ASXL1mutations are frequent and prognostically detrimental inCSF3R-mutated chronic neutrophilic leukemia|journal=American Journal of Hematology|volume=90|issue=7|year=2015|pages=653–656|issn=03618609|doi=10.1002/ajh.24031}}</ref><ref>{{cite web|url=http://packageinserts.bms.com/pi/pi_hydrea.pdf|title=Hydrea (Hydroxyurea Package Insert)}}</ref>
***Preferred regimen: 20-30 mg/kg administered orally as a single dose daily, for 6 weeks
***Preferred regimen: 20-30 mg/kg PO as a single dose daily, for 6 weeks
***'''Note (1)''': Hydroxyurea is the most effective drug in controlling of leukocytosis and splenomegaly
***'''Note (1)''': Hydroxyurea is the most effective drug in controlling of leukocytosis and splenomegaly
***'''Note (2):''' Hydroxyurea is used before progressive or blast transformation stages
***'''Note (2):''' Hydroxyurea is used before progressive or blast transformation stages
**2. [[Ruxolitinib]] :  Based on the role of [[Ruxolitinib]] on [[JAK-STAT pathway]] and this pathway is also had role in [[pathogenesis]] of CNL, it can be used in treatment of [[patients]] with CNL.<ref name="SzuberTefferi2018" />
**2. [[Ruxolitinib]] :  Based on the role of [[Ruxolitinib]] on [[JAK-STAT pathway]] and this pathway is also had role in [[pathogenesis]] of CNL, it can be used in treatment of [[patients]] with CNL.<ref name="SzuberTefferi2018" />
***Preferred regimen in myeloproliferative disorders based on platelet count:
***Preferred regimen in myeloproliferative disorders based on platelet count:
****Greater than 200
****Greater than 200×10<sup>9</sup>/L: 20 mg PO q12h
****100 to 200
****100 to 200×10<sup>9</sup>/L: 15 mg PO q12h
****50 to less than 100
****50 to less than 100×10<sup>9</sup>/L: 5 mg PO q12h
**[[Interferon]] : IFN-α is used in some [[patients]] but the [[result]] of responding to this drug was not equal.<ref>{{Cite journal
****'''Note (1) :''' Monitoring of complete blood counts every 2 to 4 weeks should be done until doses are stabilized
**
**
*Alternative ones:
*[[Interferon]] : IFN-α is used in some [[patients]] but the [[result]] of responding to this drug was not equal.<ref>{{Cite journal
  | author = [[M. A. Elliott]], [[G. W. Dewald]], [[A. Tefferi]] & [[C. A. Hanson]]
  | author = [[M. A. Elliott]], [[G. W. Dewald]], [[A. Tefferi]] & [[C. A. Hanson]]
  | title = Chronic neutrophilic leukemia (CNL): a clinical, pathologic and cytogenetic study
  | title = Chronic neutrophilic leukemia (CNL): a clinical, pathologic and cytogenetic study
Line 29: Line 33:
  | pmid = 11243396
  | pmid = 11243396
}}</ref>
}}</ref>
**
*Alternative ones:
**[[Thalidomide]]
**[[Thalidomide]]
**[[Cladribine]]
**[[Cladribine]]

Revision as of 20:32, 1 February 2019

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Homa Najafi, M.D.[2]

Overview

There is no treatment for chronic neutrophilic leukemia (CNL). Although, hematopoitic stem cell transplant, hydroxyurea, interferon, hypomethylating agents, ruxolitinib, thalidomide, cladribine, imatinib, splenic irradiation and splenectomy are some options that are used in patients with CNL.

Chronic neutrophilic leukemia Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Epidemiology and Demographics

Risk Factors

Screening

Differentiating Chronic neutrophilic leukemia from other Diseases

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X Ray

CT scan

MRI

Echocardiography and Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Interventions

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Chronic neutrophilic leukemia medical therapy On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Chronic neutrophilic leukemia medical therapy

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Chronic neutrophilic leukemia medical therapy

CDC on Chronic neutrophilic leukemia medical therapy

Chronic neutrophilic leukemia medical therapy in the news

Blogs on Chronic neutrophilic leukemia medical therapy

Directions to Hospitals Treating Chronic neutrophilic leukemia

Risk calculators and risk factors for Chronic neutrophilic leukemia medical therapy

Medical Therapy

There is no established treatment for patients with CNL. However, following options may be useful in treatment of patients with CNL:[1][2][3]

  • Preffered ones:
    • 1. Hydroxyurea:[1][4][5]
      • Preferred regimen: 20-30 mg/kg PO as a single dose daily, for 6 weeks
      • Note (1): Hydroxyurea is the most effective drug in controlling of leukocytosis and splenomegaly
      • Note (2): Hydroxyurea is used before progressive or blast transformation stages
    • 2. Ruxolitinib : Based on the role of Ruxolitinib on JAK-STAT pathway and this pathway is also had role in pathogenesis of CNL, it can be used in treatment of patients with CNL.[2]
      • Preferred regimen in myeloproliferative disorders based on platelet count:
        • Greater than 200×109/L: 20 mg PO q12h
        • 100 to 200×109/L: 15 mg PO q12h
        • 50 to less than 100×109/L: 5 mg PO q12h
        • Note (1) : Monitoring of complete blood counts every 2 to 4 weeks should be done until doses are stabilized
  • Alternative ones:
  • Interferon : IFN-α is used in some patients but the result of responding to this drug was not equal.[6]

References

  1. 1.0 1.1 Elliott, M A; Hanson, C A; Dewald, G W; Smoley, S A; Lasho, T L; Tefferi, A (2004). "WHO-defined chronic neutrophilic leukemia: a long-term analysis of 12 cases and a critical review of the literature". Leukemia. 19 (2): 313–317. doi:10.1038/sj.leu.2403562. ISSN 0887-6924.
  2. 2.0 2.1 Szuber, Natasha; Tefferi, Ayalew (2018). "Chronic neutrophilic leukemia: new science and new diagnostic criteria". Blood Cancer Journal. 8 (2). doi:10.1038/s41408-018-0049-8. ISSN 2044-5385.
  3. You W, Weisbrot IM (1979). "Chronic neutrophilic leukemia. Report of two cases and review of the literature". Am J Clin Pathol. 72 (2): 233–42. PMID 289288.
  4. Elliott, Michelle A.; Pardanani, Animesh; Hanson, Curtis A.; Lasho, Terra L.; Finke, Christy M.; Belachew, Alem A.; Tefferi, Ayalew (2015). "ASXL1mutations are frequent and prognostically detrimental inCSF3R-mutated chronic neutrophilic leukemia". American Journal of Hematology. 90 (7): 653–656. doi:10.1002/ajh.24031. ISSN 0361-8609.
  5. "Hydrea (Hydroxyurea Package Insert)" (PDF).
  6. M. A. Elliott, G. W. Dewald, A. Tefferi & C. A. Hanson (2001). "Chronic neutrophilic leukemia (CNL): a clinical, pathologic and cytogenetic study". Leukemia. 15 (1): 35–40. PMID 11243396. Unknown parameter |month= ignored (help)

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