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{{Chronic neutrophilic leukemia}}
{{Chronic neutrophilic leukemia}}
{{CMG}}; {{AE}}
{{CMG}}; {{AE}} {{Homa}}; {{GRR}} {{Nat}}
 
==Overview==
==Overview==
There is no treatment for [disease name]; the mainstay of therapy is supportive care.
There is no standard medical treatment for chronic neutrophilic leukemia (CNL). Although, [[Hydroxyurea]], [[Ruxolitinib]], [[Interferon]], [[Thalidomide]], [[Cladribine]] and [[Imatinib]] are some options that are used in [[patients]] with CNL.
 
OR
 
Supportive therapy for [disease name] includes [therapy 1], [therapy 2], and [therapy 3].
 
OR
 
The majority of cases of [disease name] are self-limited and require only supportive care.
 
OR
 
[Disease name] is a medical emergency and requires prompt treatment.
 
OR
 
The mainstay of treatment for [disease name] is [therapy].
 
OR
 
The optimal therapy for [malignancy name] depends on the stage at diagnosis.
 
OR
 
[Therapy] is recommended among all patients who develop [disease name].
 
OR
 
Pharmacologic medical therapy is recommended among patients with [disease subclass 1], [disease subclass 2], and [disease subclass 3].
 
OR
 
Pharmacologic medical therapies for [disease name] include (either) [therapy 1], [therapy 2], and/or [therapy 3].
 
OR
 
Empiric therapy for [disease name] depends on [disease factor 1] and [disease factor 2].
 
OR
 
Patients with [disease subclass 1] are treated with [therapy 1], whereas patients with [disease subclass 2] are treated with [therapy 2].


{{Chronic neutrophilic leukemia}}
==Medical Therapy==
==Medical Therapy==
*Pharmacologic medical therapy is recommended among patients with [disease subclass 1], [disease subclass 2], and [disease subclass 3].  
There is no established treatment for patients with CNL. However, following options may be useful in treatment of patients with CNL:<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="SzuberTefferi2018">{{cite journal|last1=Szuber|first1=Natasha|last2=Tefferi|first2=Ayalew|title=Chronic neutrophilic leukemia: new science and new diagnostic criteria|journal=Blood Cancer Journal|volume=8|issue=2|year=2018|issn=2044-5385|doi=10.1038/s41408-018-0049-8}}</ref><ref name="pmid289288">{{cite journal| author=You W, Weisbrot IM| title=Chronic neutrophilic leukemia. Report of two cases and review of the literature. | journal=Am J Clin Pathol | year= 1979 | volume= 72 | issue= 2 | pages= 233-42 | pmid=289288 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=289288  }} </ref>
*Pharmacologic medical therapies for [disease name] include (either) [therapy 1], [therapy 2], and/or [therapy 3].
* Preffered ones:
*Empiric therapy for [disease name] depends on [disease factor 1] and [disease factor 2].
**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>
*Patients with [disease subclass 1] are treated with [therapy 1], whereas patients with [disease subclass 2] are treated with [therapy 2].
***Preferred regimen: 20-30 mg/kg PO as a single dose daily, for 6 weeks
===Disease Name===
***'''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.<ref name="SzuberTefferi2018" /><ref>{{Cite journal
| author = [[Leah Wolfe]]
| title = Ruxolitinib in Myelofibrosis and Polycythemia Vera
| journal = [[Journal of the advanced practitioner in oncology]]
| volume = 7
| issue = 4
| pages = 436–444
| year = 2016
| month = May-June
| pmid = 29226001
}}</ref>
***Preferred regimen in [[Myeloproliferative disease|myeloproliferative disorders]] based on [[platelet count]]:
****Greater than 200×10<sup>9</sup>/L: 20 mg PO q12h
****100 to 200×10<sup>9</sup>/L: 15 mg PO q12h
****50 to less than 100×10<sup>9</sup>/L: 5 mg PO q12h
***'''Note (1) :''' Monitoring of [[complete blood counts]] every 2 to 4 weeks should be done until doses are stabilized.


* '''1 Stage 1 - Name of stage'''
*Alternative ones:
** 1.1 '''Specific Organ system involved 1'''
**1.[[Interferon]] : IFN-α is used in some [[patients]] but the [[result]] of responding to this drug was not equal.<ref>{{Cite journal
*** 1.1.1 '''Adult'''
| author = [[M. A. Elliott]], [[G. W. Dewald]], [[A. Tefferi]] & [[C. A. Hanson]]
**** Preferred regimen (1): [[drug name]] 100 mg PO q12h for 10-21 days '''(Contraindications/specific instructions)''' 
| title = Chronic neutrophilic leukemia (CNL): a clinical, pathologic and cytogenetic study
**** Preferred regimen (2): [[drug name]] 500 mg PO q8h for 14-21 days
| journal = [[Leukemia]]
**** Preferred regimen (3): [[drug name]] 500 mg q12h for 14-21 days
| volume = 15
**** Alternative regimen (1): [[drug name]] 500 mg PO q6h for 7–10 days 
| issue = 1
**** Alternative regimen (2): [[drug name]] 500 mg PO q12h for 14–21 days
  | pages = 35–40
**** Alternative regimen (3): [[drug name]] 500 mg PO q6h for 14–21 days
  | year = 2001
*** 1.1.2 '''Pediatric'''
  | month = January
**** 1.1.2.1 (Specific population e.g. '''children < 8 years of age''')
  | pmid = 11243396
***** Preferred regimen (1): [[drug name]] 50 mg/kg PO per day q8h (maximum, 500 mg per dose) 
}}</ref>
***** Preferred regimen (2): [[drug name]] 30 mg/kg PO per day in 2 divided doses (maximum, 500 mg per dose)
**2.[[Thalidomide]]
***** Alternative regimen (1): [[drug name]]10 mg/kg PO q6h (maximum, 500 mg per day)
**3.[[Cladribine]]
***** Alternative regimen (2): [[drug name]] 7.5 mg/kg PO q12h (maximum, 500 mg per dose)
**4.[[Imatinib]]
***** Alternative regimen (3): [[drug name]] 12.5 mg/kg PO q6h (maximum, 500 mg per dose)
****1.1.2.2 (Specific population e.g. '<nowiki/>'''''children < 8 years of age'''''')
***** Preferred regimen (1): [[drug name]] 4 mg/kg/day PO q12h（maximum, 100 mg per dose）
***** Alternative regimen (1): [[drug name]] 10 mg/kg PO q6h (maximum, 500 mg per day)
***** Alternative regimen (2): [[drug name]] 7.5 mg/kg PO q12h (maximum, 500 mg per dose) 
***** Alternative regimen (3): [[drug name]] 12.5 mg/kg PO q6h (maximum, 500 mg per dose)
** 1.2 '''Specific Organ system involved 2'''
*** 1.2.1 '''Adult'''
**** Preferred regimen (1): [[drug name]] 500 mg PO q8h
*** 1.2.2  '''Pediatric'''
**** Preferred regimen (1): [[drug name]] 50 mg/kg/day PO q8h (maximum, 500 mg per dose)
 
* 2 '''Stage 2 - Name of stage'''
** 2.1 '''Specific Organ system involved 1 '''
**: '''Note (1):'''
**: '''Note (2)''':
**: '''Note (3):'''
*** 2.1.1 '''Adult'''
**** Parenteral regimen
***** Preferred regimen (1): [[drug name]] 2 g IV q24h for 14 (14–21) days
***** Alternative regimen (1): [[drug name]] 2 g IV q8h for 14 (14–21) days
***** Alternative regimen (2): [[drug name]] 18–24 MU/day IV q4h for 14 (14–21) days
**** Oral regimen
***** Preferred regimen (1): [[drug name]] 500 mg PO q8h for 14 (14–21) days
***** Preferred regimen (2): [[drug name]] 100 mg PO q12h for 14 (14–21) days
***** Preferred regimen (3): [[drug name]] 500 mg PO q12h for 14 (14–21) days
***** Alternative regimen (1): [[drug name]] 500 mg PO q6h for 7–10 days 
***** Alternative regimen (2): [[drug name]] 500 mg PO q12h for 14–21 days
***** Alternative regimen (3):[[drug name]] 500 mg PO q6h for 14–21 days
*** 2.1.2 '''Pediatric'''
**** Parenteral regimen
***** Preferred regimen (1): [[drug name]] 50–75 mg/kg IV q24h for 14 (14–21) days (maximum, 2 g)
***** Alternative regimen (1): [[drug name]] 150–200 mg/kg/day IV q6–8h for 14 (14–21) days (maximum, 6 g per day)
***** Alternative regimen (2):  [[drug name]] 200,000–400,000 U/kg/day IV q4h for 14 (14–21) days (maximum, 18–24 million U per day) '<nowiki/>'''''(Contraindications/specific instructions)''''''
**** Oral regimen
***** Preferred regimen (1):  [[drug name]] 50 mg/kg/day PO q8h for 14 (14–21) days  (maximum, 500 mg per dose)
***** Preferred regimen (2): [[drug name]] '''(for children aged ≥ 8 years)''' 4 mg/kg/day PO q12h for 14 (14–21) days (maximum, 100 mg per dose)
***** Preferred regimen (3): [[drug name]] 30 mg/kg/day PO q12h for 14 (14–21) days (maximum, 500 mg per dose)
***** Alternative regimen (1): [[drug name]] 10 mg/kg PO q6h 7–10 days  (maximum, 500 mg per day)
***** Alternative regimen (2): [[drug name]] 7.5 mg/kg PO q12h for 14–21 days (maximum, 500 mg per dose)
***** Alternative regimen (3): [[drug name]] 12.5 mg/kg PO q6h for 14–21 days (maximum,500 mg per dose)
** 2.2  '<nowiki/>'''''Other Organ system involved 2''''''
**: '''Note (1):'''
**: '''Note (2)''':
**: '''Note (3):'''
*** 2.2.1 '''Adult'''
**** Parenteral regimen
***** Preferred regimen (1): [[drug name]] 2 g IV q24h for 14 (14–21) days
***** Alternative regimen (1): [[drug name]] 2 g IV q8h for 14 (14–21) days
***** Alternative regimen (2): [[drug name]] 18–24 MU/day IV q4h for 14 (14–21) days
**** Oral regimen
***** Preferred regimen (1): [[drug name]] 500 mg PO q8h for 14 (14–21) days
***** Preferred regimen (2): [[drug name]] 100 mg PO q12h for 14 (14–21) days
***** Preferred regimen (3): [[drug name]] 500 mg PO q12h for 14 (14–21) days
***** Alternative regimen (1): [[drug name]] 500 mg PO q6h for 7–10 days 
***** Alternative regimen (2): [[drug name]] 500 mg PO q12h for 14–21 days
***** Alternative regimen (3):[[drug name]] 500 mg PO q6h for 14–21 days
*** 2.2.2 '''Pediatric'''
**** Parenteral regimen
***** Preferred regimen (1): [[drug name]] 50–75 mg/kg IV q24h for 14 (14–21) days (maximum, 2 g)
***** Alternative regimen (1): [[drug name]] 150–200 mg/kg/day IV q6–8h for 14 (14–21) days (maximum, 6 g per day)
***** Alternative regimen (2):  [[drug name]] 200,000–400,000 U/kg/day IV q4h for 14 (14–21) days (maximum, 18–24 million U per day)
**** Oral regimen
***** Preferred regimen (1):  [[drug name]] 50 mg/kg/day PO q8h for 14 (14–21) days  (maximum, 500 mg per dose)
***** Preferred regimen (2): [[drug name]] 4 mg/kg/day PO q12h for 14 (14–21) days (maximum, 100 mg per dose)
***** Preferred regimen (3): [[drug name]] 30 mg/kg/day PO q12h for 14 (14–21) days  (maximum, 500 mg per dose)
***** Alternative regimen (1):  [[drug name]] 10 mg/kg PO q6h 7–10 days  (maximum, 500 mg per day)
***** Alternative regimen (2): [[drug name]] 7.5 mg/kg PO q12h for 14–21 days  (maximum, 500 mg per dose)
***** Alternative regimen (3): [[drug name]] 12.5 mg/kg PO q6h for 14–21 days  (maximum,500 mg per dose)


==References==
==References==
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[[Category:Up-To-Date]]
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[[Category:Medicine]]
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[[Category:Up-To-Date]]​
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[[Category:Immunology]]

Latest revision as of 20:57, 29 July 2020

Chronic neutrophilic leukemia Microchapters

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Overview

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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]; Grammar Reviewer: Natalie Harpenau, B.S.[3]

Overview

There is no standard medical treatment for chronic neutrophilic leukemia (CNL). Although, Hydroxyurea, Ruxolitinib, Interferon, Thalidomide, Cladribine and Imatinib 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]

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. ↑ Leah Wolfe (2016). "Ruxolitinib in Myelofibrosis and Polycythemia Vera". Journal of the advanced practitioner in oncology. 7 (4): 436–444. PMID 29226001. Unknown parameter |month= ignored (help)
  7. ↑ 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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