Chronic neutrophilic leukemia medical therapy

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]

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.

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][6]
    • 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:
  • 1.Interferon : IFN-α is used in some patients but the result of responding to this drug was not equal.^[7]
  • 2.Thalidomide
  • 3.Cladribine
  • 4.Imatinib

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