Constitutional syndrome and leukocytosis in a woman aged 74 years

Neutrophilia may be reactive to systemic disease. Excluded reactive causes, the possibility of clonal diseases must be considered, as chronic myeloproliferative neoplasms (NMP) and SMD/NMP are. Neutrophilic myeloid neoplasms diagnosis and classification pose a challenge, because clinical features superposition among them. If the patient do not fit the criterions of those entities fully, has overlapping characteristics and morphological dysplasia, a SMD/NMP-NOS diagnosis must be argued, in spite of difficulties account its rarity and heterogeneity. Next generation sequencing methods provide key information about the neutrophilic myeloid neoplasms and SMD/NMP diagnosis, identifying in nearly all patients one somatic mutation al least. Overlapping mutation profile is recognized in those entities, although rather more heterogeneous in SMD/NMP-NOS. Patient phenotype would be the result of the clinical associations linked to her clonal complexity.