Myeloproliferative Disorder

Eileen Scigliano, MD

Mount Sinai School of Medicine, New York, NY

This case was reviewed and updated in March 2013 by Dr. Marc J. Kahn and members of the Teaching Cases Subcommittee.

Comparison of CML and Reactive Granulocytosis
	Chronic Myelogenous Leukemia	Reactive Granulocytosis
Pathophysiology	Clonal, autonomous proliferation of hematopoietic cells	Cytokine-induced increase in bone marrow production, release and demargination of granulocytes, secondary to infection, inflammation or malignancy
Clinical features	Patient often asymptomatic; splenomegaly	Signs of infection, inflammation or malignancy
CBC	Granulocytosis with left shift; thrombocytosis; basophilia	Granulocytosis with left shift; thrombocytosis (rarely > 1,000/µL)
Cytogenetic studies	Philadelphia chromosome present	Normal
Molecular studies	Chimeric BCR-ABL gene present by FISH and PCR analysis	Normal
Treatment	Imatinib mesylate Allogeneic stem cell transplant	Treat underlying cause

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