Differential Diagnosis for Leukaemia in the Elderly with High Neutrophils
- Single most likely diagnosis
- Chronic Myeloid Leukaemia (CML): This is the most likely diagnosis as CML often presents with elevated neutrophil counts, and it can occur in the elderly. The presence of the Philadelphia chromosome is a hallmark of CML.
- Other Likely diagnoses
- Chronic Neutrophilic Leukaemia (CNL): This rare condition is characterized by sustained neutrophilia without the Philadelphia chromosome. It's more common in the elderly and can present with high neutrophil counts.
- Myeloproliferative Neoplasm (MPN) - associated neutrophilia: Conditions like Polycythemia Vera or Essential Thrombocythemia can sometimes present with elevated neutrophil counts, especially in the elderly.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Leukaemic Transformation of Myelodysplastic Syndrome (MDS): MDS can transform into acute myeloid leukaemia (AML), which may present with high neutrophil counts. Missing this diagnosis could be fatal due to the aggressive nature of AML.
- Acute Myeloid Leukaemia (AML) with maturation: AML with maturation can present with high neutrophil counts and is a medical emergency requiring prompt treatment.
- Rare diagnoses
- Atypical Chronic Myeloid Leukaemia (aCML): This is a rare condition that presents with features of both CML and MDS, including neutrophilia. It's essential to consider this diagnosis in the elderly with high neutrophil counts and other myelodysplastic features.
- Chronic Myelomonocytic Leukaemia (CMML): Although CMML typically presents with monocytosis, some cases can have prominent neutrophilia, making it a rare consideration in this differential diagnosis.