Chronic neutrophilic leukemia medical therapy
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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 |
|
Differentiating Chronic neutrophilic leukemia from other Diseases |
|---|
|
Diagnosis |
|
Treatment |
|
Case Studies |
|
Chronic neutrophilic leukemia medical therapy On the Web |
|
American Roentgen Ray Society Images of 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
- Preferred regimen in myeloproliferative disorders based on platelet count:
- 1. Hydroxyurea:[1][4][5]
- Alternative ones:
- Interferon : IFN-α is used in some patients but the result of responding to this drug was not equal.[6]
- Thalidomide
- Cladribine
- Imatinib
References
- ↑ 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.
- ↑ 2.0 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.
- ↑ 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.
- ↑ 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.
- ↑ "Hydrea (Hydroxyurea Package Insert)" (PDF).
- ↑ 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
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