We are reporting four patients who presented with a persistent increase of mature neutrophils and band forms, no monocytosis in repeated examinations and with dysplastic features in blood and bone marrow. Two of them developed acute myeloid leukemia (AML; FAB classification M1) and the other two were characterised by a progressively aggravating myelodysplasia. All the patients showed a poor response to treatment and died within a period of time ranging from 14 to 80 months after diagnosis. We are proposing the term chronic neutrophilic leukemia with dysplastic features (CNL-D) for this entity, and we believe that it represents a variant of the myelodysplastic syndromes.

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