Leukemia - Spontaneous Remission Database

Leukemia

Epidemiology:

Leukemia ranks among the most prevalent and impactful hematologic malignancies worldwide, with an estimated incidence of approximately 1,343,850 cases reported globally in 2019¹. In the United States, the annual incidence of leukemia is around 61,780 new cases, with approximately 22,840 fatalities, underscoring its significant public health burden². Despite advances in treatments, leukemia continues to represent a leading cause of cancer-related death, reflective of its complex pathophysiology and the challenges associated with effective management³. Spontaneous remission (SR) in leukemia is exceptionally rare, occurring in fewer than 1% of diagnosed cases, with such instances often characterized by their dramatic and sustained nature, complicating efforts to accurately assess their true prevalence due to underreporting or transient remission episodes.^4,5

Clinical Characteristics:

A total of 110 well-documented cases of SR in leukemia have been reported between 1949 and 2025. The ages of affected individuals ranged from newborn to 88 years (mean ≈ 53 years), with a near-equal male-to-female ratio of approximately 1.1:1 and a peak incidence in the 50–70-year age group. Overall, SR tended to occur in older adults and occasionally in infants with congenital leukemia, with remission most often observed in systemic disease rather than localized forms. See table 1 below for further information.

Histological Characteristics:

Patients who experienced spontaneous remission of leukemia typically presented with hematologic abnormalities such as leukocytosis, cytopenia, or organomegaly, and the diagnosis was confirmed through peripheral blood and bone marrow examinations showing leukemic cell infiltration. Most cases involved advanced or systemic disease, with the bone marrow and peripheral blood being the predominant primary sites, and occasional extramedullary involvement of the skin, lymph nodes, liver, or spleen. Remission was verified by normalizing hematologic parameters and bone marrow findings demonstrating leukemic cells' disappearance or marked reduction. Nearly all SR cases were associated with durable hematologic recovery or long-term disease stability, substantially exceeding the expected prognosis for untreated leukemia.

Proposed Contributing Mechanisms:

Various mechanisms have been proposed to explain spontaneous remission in leukemia. The most frequently reported involve infection-induced immune activation, often following bacterial or viral illness, sepsis, or febrile episodes. Additional contributing factors included transfusion-related immune responses, T-lymphocytic hyperplasia, endogenous interferon activity, and hormonal or postpartum immune modulation. A few cases further described apoptotic or differentiation-related processes, such as Fas-mediated cell death or marrow recovery responses.

Site and Extent of Remission:

The bone marrow and peripheral blood were the predominant sites of both disease involvement and remission in the majority of reported leukemia SR cases. Extramedullary remissions were occasionally described, affecting the skin, lymph nodes, liver, spleen, or, rarely, the eye. In several patients, remission encompassed both medullary and extramedullary compartments, indicating systemic resolution rather than localized regression. The duration of remission varied widely, from weeks to several years, with a substantial proportion of patients achieving long-term hematologic stability or sustained remission without relapse.

Table 1: Leukemia SR Cases and Clinical Characteristics

Author–year	Age/sex	Primary site	Remission site	Proposed mechanisms	Follow-up
Birge et al., 1949⁶	33/F	Blood, bone marrow	Blood, bone marrow	Postpartum immune recovery	21 months
Pelner et al., 1958⁷	Not reported (350 patients, mixed group)	Blood	Blood	Infection-induced immune response	Not reported
Ngu, 1967⁸	4/M	Maxillae, mandibles, left cheek, right eyelid	Jaw and facial tumors	Passive immune transfer	3 months
Chervenick et al., 1967⁹	63/M	Blood	Blood	Not reported	11 years
Nagao et al., 1970¹⁰	Newborn/M	Bone marrow	Blood, bone marrow	Not reported	Not reported
Wiernik, 1976¹¹	Not reported	Blood, bone marrow	Blood, bone marrow	Bacterial or viral infection	Weeks to years
Lebedev et al., 1976¹²	Three males	Blood, bone marrow	Blood, bone marrow	Not reported	6–10 years
Lebedev et al., 1976¹²	37/F	Abdominal lymph nodes	Blood, bone marrow, lymph nodes	Not reported	5 years
Hansen & Libnoch, 1978¹³	78/M	Blood, bone marrow	Bone marrow, lymph nodes	Immune stimulation	3 years
Lachant et al., 1979¹⁴	67/F	Bone marrow	Lung, bone marrow	Infection-induced immune activation	19 months
Long et al., 1979¹⁵	7/F	Bone marrow	Blood and bone marrow	Not reported	4.5 months
Ragni & Shreiner, 1981¹⁶	Two Males	Bone marrow	Bone marrow	Not reported	22 and 16 months
Hughes et al., 1981¹⁷	58/M	Bone marrow	Bone marrow	Not reported	>2 years
Kimura et al., 1983¹⁸	36/M	Peripheral blood	Skin, lungs	Infection-induced immune activation	4 years
Silingardi et al., 1985¹⁹	53/M	Bone marrow	Liver, spleen, bone marrow	Infection-induced immune activation	17 years
Smadja et al., 1986²⁰	27/M	Bone marrow	Bone marrow	Not reported	8 years
Ribera et al., 1987²¹	49/F	Bone marrow	Lymph nodes, spleen, Waldeyer’s ring	Infection-induced immune activation	Not reported
Ribera et al., 1987²¹	57/F	Bone marrow	Lymph nodes, spleen, bone marrow	Not reported	Not reported
Deharo et al., 1987²²	Not reported	Blood	Blood	Infection-induced immune activation	Not reported
Gottesfeld et al., 1989²³	Newborn/M	Bone marrow	Skin	Not reported	26 months
Grundy et al., 2000²⁴	Newborn/M	Skin (congenital leukemia cutis)	Skin	Not reported	26 months
Jeha et al., 2000²⁵	12/M	Bone marrow, blood	Bone marrow, blood	G-CSF withdrawal	6 months
Martelli et al., 2000²⁶	26/F	Bone marrow	Bone marrow	Infection-induced immune response	25 months
Mora et al., 2000²⁷	Newborn/F (twin A)	Skin	Skin, Bone marrow	Self-limited leukemic clone	Not reported
Mora et al., 2000²⁷	Newborn/F (twin B)	Skin	Skin, Bone marrow	Self-limited leukemic clone	Not reported
Muraki et al., 2000²⁸	88/F	Bone marrow	Bone marrow, blood	Fas-mediated apoptosis	Not reported
Upshaw et al., 2002²⁹	83/M	Bone marrow	Bone marrow, blood	T-lymphocyte activation or hyperplasia	8 years
Thomas et al., 2002³⁰	60/F	Bone marrow	Blood and lymph nodes	Natural regulatory mechanism	Not reported
Thomas et al., 2002³⁰	69/M	Bone marrow	Blood, Bone Marrow, lymph nodes	Natural regulatory mechanism	Not reported
Thomas et al., 2002³⁰	70/F	Bone marrow	Blood, bone marrow	Natural regulatory mechanism	10 years
Thomas et al., 2002³⁰	51/F	Bone marrow	Blood and lymph nodes	Natural regulatory mechanism	6 years
Thomas et al., 2002³⁰	54/M	Bone marrow	Blood and lymph nodes	Natural regulatory mechanism	7 years
Thomas et al., 2002³⁰	73/F	Bone marrow	Blood, bone marrow	Natural regulatory mechanism	11 years
Thomas et al., 2002³⁰	69/F	Bone marrow	Blood, spleen, and bone marrow	Natural regulatory mechanism	4 years
Thomas et al., 2002³⁰	57/M	Bone marrow	Blood, spleen, and bone marrow	Natural regulatory mechanism	13 years
Thomas et al., 2002³⁰	47/M	Bone marrow	Blood, lymph nodes, and spleen	Natural regulatory mechanism	18 years
Sosin & Handa, 2003³¹	82/M	Blood	Blood	Infection-related immune activation	18 months
Kazakov et al., 2003³²	79/M	Skin	Skin	Not reported	18 months
Maywald et al., 2003³³	31/M	Bone marrow	Bone marrow	Infection-induced immune response	2 months
Morris, 2003³⁴	74/F	Bone marrow	Bone marrow, blood	T-lymphocytic hyperplasia	Not reported
Bassan et al., 2003³⁵	61–67/Maj F	Spleen	Blood, spleen	Cytokine suppression, immune modulation	15 years
Fozza et al., 2004³⁶	72/M	Bone marrow, blood	Bone marrow, blood	Cross-activated immune response	5 months
Müller et al., 2004³⁷	61/M	Bone marrow	Bone marrow, blood	Infection-induced immune response	29 months
Shichishima et al., 2004³⁸	69/M	Bone marrow	Bone marrow, blood	Cellular phenotype abnormality	39 months
Shichishima et al., 2004³⁸	46/M	Bone marrow	Bone marrow, blood	Cellular phenotype or immune modulation	7 years
Lander et al., 2005³⁹	Newborn/M	Skin, bone marrow	Skin	Not reported	8 months
Sonneck et al., 2005⁴⁰	56/F	Bone marrow	Bone marrow, blood	Transfusion-related immune response	Not reported
Tsavaris et al., 2006⁴¹	64/M	Bone marrow	Bone marrow, blood	Hormonal modulation via GnRH agonist	4 years
Daccache et al., 2007⁴²	83/F	Bone marrow, blood	Bone marrow, blood	Immune response	2.5 months
Jankipersadsing et al., 2007⁴³	49/F	Lungs	Pulmonary infiltrates (lungs)	Not reported	1 year
Trof et al., 2007⁴⁴	29/M	Bone marrow	Blood, bone marrow	Sepsis-induced cytokines	6 months
Trof et al., 2007⁴⁴	28/M	Bone marrow	Blood, bone marrow	Sepsis-induced cytokines	1 month
Yoruk et al., 2008⁴⁵	4/F	Blood	Bone marrow, mediastinal mass	Infection-induced immune activation	Not reported
Kanegane et al., 2009⁴⁶	6 months/M	Skin	Skin, bone marrow	Not reported	1 year
Marisavlievic et al., 2009⁴⁷	63/M	Bone marrow	Bone marrow	Transfusion-related immune response	7 years
Bernardeschi & Pirrotta, 2010⁴⁸	40/F (pregnant)	Blood	Blood	Elevated interferon levels during pregnancy	Not reported
Teng et al., 2011⁴⁹	75/M	Bone marrow	Bone marrow, blood	Infection-induced immune activation	21 weeks
Wu et al., 2011⁵⁰	Newborn/F	Skin and bone marrow	Skin and bone marrow	Not reported	11 months
Alsultan et al., 2012⁵¹	29 months/M	Blood, bone marrow	Blood, bone marrow	Not reported	>2 years
Boonchalermyichian et al., 2012⁵²	50/F	Bone marrow, blood	Bone marrow, blood	Immune response	5 months
Elhasid et al., 2012⁵³	9 months/M	Bone marrow	Bone marrow	Immune activation	4 months
Herishanu et al., 2012⁵⁴	54/M	Lymph nodes	Lymph nodes, bone marrow	Cancer immune surveillance	3 years
Xie et al., 2012⁵⁵	42/M	Bone marrow and blood	Bone marrow and blood	Cytokine-mediated immune response	2 Years
Zeng et al., 2013⁵⁶	31/M	Bone marrow, lung	Bone marrow	Immune response to infection	Not reported
Zeng et al., 2013⁵⁶	34/F	Bone marrow, skin	Bone marrow	Immune response to infection	Not reported
Nakhla et al., 2013⁵⁷	70/M	Blood	Blood	Not reported	5 months
Adam & Eltayeb, 2014⁵⁸	35/M	Blood, bone marrow	Bone marrow	Immune response, blood transfusion	6 weeks
Yasuda et al., 2014⁵⁹	67/M	Skin, stomach	Skin lesions	Not reported	Not reported
Purohit et al., 2015⁶⁰	46/M	Blood, bone marrow	Blood, bone marrow	Not reported	Not reported
Kumar et al., 2015⁶¹	7/M	Bone marrow, blood	Bone marrow, blood	Parvovirus B19–induced cytotoxicity	4 years
Vachhani et al., 2016⁶²	73/F	Blood, bone marrow	Bone marrow	Innate host immune responses	Not reported
Jesudas et al., 2017⁶³	2months/F	Skin, bone marrow	Skin, bone marrow	Not reported	6 weeks
Barrett et al., 2017⁶⁴	Infant/F	Skin, bone marrow	Skin, bone marrow	Not reported	5 months
Mozafari et al., 2017⁶⁵	53/M	Bone marrow, blood	Bone marrow	Immune activation	Not reported
Ikawa et al., 2018⁶⁶	Newborn/F	Bone marrow	Bone marrow	Congenital AML, chromosome 8 translocation	3 months
Höres et al., 2018⁶⁷	31/F	Blood	Blood	Infection-induced cytokine immune response	6 weeks
Iqbal et al., 2018⁶⁸	15 months/F	Bone marrow	Bone marrow	Infection-induced cytokine immune response	173 days
Hoshino et al., 2018⁶⁹	49/F	Bone marrow	Bone marrow	Not reported	4 months
Grunwald et al., 2019⁷⁰	72/M	Bone marrow	Bone marrow, skin	Not reported	Not reported
Suyama et al., 2019⁷¹	67/M	Bone marrow	Bone marrow	Immune response	Not reported
Rautenberg et al., 2019⁷²	42/F	Bone marrow	Bone marrow	Infection-induced immune response	Not reported
Suzuki et al., 2019⁷³	47/F	Blood	Skin	Cytotoxic response	Not reported
Bradley et al., 2020⁷⁴	58/M	Bone marrow	Bone marrow	Marrow stress response	Not reported
Kubo et al., 2020⁷⁵	36 days/F	Bone marrow	Bone marrow	Not reported	Not reported
Martínez-Díez et al., 2022⁷⁶	71/M	Blood	Bone marrow	Infection-induced immune activation	Not reported
Bülbül et al., 2022⁷⁷	67/M	Blood	Bone marrow	Cytokine-induced antitumor immunity	5 months
Barkhordar et al., 2022⁷⁸	57/F	Bone marrow	Bone marrow	Infection-induced immune response	6 months
Alshurafa et al., 2023⁷⁹	56/M	Blood	Bone marrow	Not reported	5 months
Imataki et al., 2023⁸⁰	80/F	Blood	Bone marrow	Infection-induced immune activation	15 months
McCormick et al., 2024⁸¹	3/F	Bone marrow	Bone marrow	Sepsis-induced cytokines	Not reported
Diral et al., 2024⁸²	65/F	Bone marrow	Eye (choroid)	Not reported	1 year
Peñuela et al., 2024⁸³	25/F	Blood	Bone marrow	Immune response	5 months
Higaki-Mori et al., 2025⁸⁴	47/M	Skin	Skin	Not reported	Not reported
Southam et al., 1951⁸⁵	One hundred seventy-two cases of acute leukemia seen at Memorial Hospital from 1926 through 1948		8.7% of the 150 patients experienced some degree of temporary remission but that only 4.0% had complete temporary remissions. No patient in this group had more than a single remission. Remissions appeared unrelated to type of preceding treatment or to infection.	Remissions may be causally related to the infectious process, but the evidence for such a belief seems to be only circumstantial, and it is difficult to accept a causal relationship between infection and remission in a disease characterized by marked susceptibility to infections and a relative infrequency of remissions. The possibility of adrenal stress during such periods should also be considered, in view of remissions currently being seen during treatment with adrenocorticotropic hormone and cortisone.	8.7% of the 150 patients experienced some degree of temporary remission but that only 4.0% had complete temporary remissions. No patient in this group had more than a single remission. Remissions appeared unrelated to type of preceding treatment or to infection.
Hudecek et al., 2007⁸⁶	35 years old caucasian lady	Blood	Complete remission achieved after one induction course. 6 days after relapse and treatment, patient showed a persistent CR	Infection-related immunosuppression can lead to relapse of the leukemia, while subsequent recovery of immune function can restore remission.	Complete remission achieved after one induction course. 6 days after relapse and treatment, patient showed a persistent CR
Thomas, 2009⁸⁷	60 years old man. Office worker with no his-year-oldry of any exposure to asbestos, silica, cement or wood dust.	Blood vessels	While waiting for further examination results, there was a significant spontaneous improvement in his symptoms. 9 months afterwards, resolution of lung lesions was confirmed. Inflammatory markers gradually returned to normal limits.		While waiting for further examination results, there was a significant spontaneous improvement in his symptoms. 9 months afterwards, resolution of lung lesions was confirmed. Inflammatory markers gradually returned to normal limits.
D'Arena et al., 2014⁸⁸	57-year- old woman	Blood	In December 2006 the WBC count and differential were found to be normal	immune response	In December 2006 the WBC count and differential were found to be normal
D'Arena et al., 2014⁸⁸	75-year-old woman	Blood	In October 2009 the WBC count was found to be normal (4.3 x 10^9/L), again with the presence of a clonal CLL-like clone	immune response	In October 2009 the WBC count was found to be normal (4.3 x 10^9/L), again with the presence of a clonal CLL-like clone
Kazmierczak et al., 2014⁸⁹	77-year-old man	blood	By November 2011, The complete blood count became normal, with Hb 7.8 mmol/l, WBC 4.54 G/l, and platelet count of 165.0 G/l. Repeated cytologic and immunocytometric evaluation of PB and BM showed complete hematological remission	Transfusion-associated graft versus-host-diseases and graft-versus leukemia	By November 2011, The complete blood count became normal, with Hb 7.8 mmol/l, WBC 4.54 G/l, and platelet count of 165.0 G/l. Repeated cytologic and immunocytometric evaluation of PB and BM showed complete hematological remission
Gyarfas et al., 2016⁹⁰	14- months-old girl, C-section at 34 weeks. APGAR score was 2/6/7.	bone marrowithblood oral mucosa skin	Two subsequent bone marrow punctures at the age of 3 and 5 weeks did not show any signs of leukemia, and no MLL rearrangement could be detected by FISH. Subsequently, leukocyte, erythrocyte, and thrombocyte counts recovered spontaneously, accompanied by gradual clinical improvement including complete weaning from ventilator supporight	infection or disease related cytokine release	Two subsequent bone marrow punctures at the age of 3 and 5 weeks did not show any signs of leukemia, and no MLL rearrangement could be detected by FISH. Subsequently, leukocyte, erythrocyte, and thrombocyte counts recovered spontaneously, accompanied by gradual clinical improvement including complete weaning from ventilator supporight
Gomez et al., 2002⁹¹	64 -year-old male October 1998 B-CLL 1A	bone marrowithblood	the disease was initially stable, but from June 2000 (20 months after diagnosis) a continuous decrease of the absolute lymphocyte count was observed until a normal count was achieved and thereafter a progressive decrease in the percentage of immunolobicaly positive B-CLL cells to only 0.5% of the leukocytes at the last follow-up, physical was normal and the BM exam revealed only 0.6% of leukocytes with B-CLL immunophenotype there were follow ups at 32, 34, and 42 months (Fig 1 in ARTicle)	no major mechanism proposed	the disease was initially stable, but from June 2000 (20 months after diagnosis) a continuous decrease of the absolute lymphocyte count was observed until a normal count was achieved and thereafter a progressive decrease in the percentage of immunolobicaly positive B-CLL cells to only 0.5% of the leukocytes at the last follow-up, physical was normal and the BM exam revealed only 0.6% of leukocytes with B-CLL immunophenotype there were follow ups at 32, 34, and 42 months (Fig 1 in ARTicle)
Muller-Schmah et al., 2012⁹²	61 -year-old male	Bone marrow	after IV antibiotics, clinical condition improved, and lab parameters normalized and a complete clearance of blasts from peripheral blood was observed patient was discharged after 13 days, but returned 11 days later after antibiotic change for staph and 17 days later, lab parameters including WBC and LDH returned to and remained normal follow ups monitored residual disease in the peripheral blood by right-PCR, and throughout extended follow up, right-PCR remained negative complete remission as noted by biopsy at day 96 NACE staining showed massive hypercellularity and a dense infiltration with blasts at day 1 (>90%), and day 4(>80%). The biopsy taken at day 96 contained normocellular hematopoieses without evidence of an increased amount of blasts IHC of sequential biopsies also showed an increasing infiltration with CD3+ T lymphocytes in the first and second biopsy, while at remission, only expected, interstitial and nodular T lymphocytic infiltrates were observed. the marrow biopsy at 96 days contained only <1% apoptotic cells, when at day 1 (<5%) and day 2 (15% apoptotic)	long-term disease control might be mediated bia expansion of specific T cell clones NK cells may be involved in the long-term antileukemic control (see ARTicle for more information on their study to test this) strong suggestion of contribution of a humoral antileukemic activity (e.g. cytokine- or antibody-mediate) directed against the myeloid leukemic blasts Sepsis is a possible mechanism for the activation of the immune system and clearance of leukemia, i.e. S. aureus could have stimulated the release of tumor necrosis factor alpha, interleukin-1, interleukin-6, and interleukin-8, leading to an increase in NK and cytotoxic cells remission could be due to CD8 cells and humoral mechanisms, and long-term remission could be due to NK-mediated disease control	after IV antibiotics, clinical condition improved, and lab parameters normalized and a complete clearance of blasts from peripheral blood was observed patient was discharged after 13 days, but returned 11 days later after antibiotic change for staph and 17 days later, lab parameters including WBC and LDH returned to and remained normal follow ups monitored residual disease in the peripheral blood by right-PCR, and throughout extended follow up, right-PCR remained negative complete remission as noted by biopsy at day 96 NACE staining showed massive hypercellularity and a dense infiltration with blasts at day 1 (>90%), and day 4(>80%). The biopsy taken at day 96 contained normocellular hematopoieses without evidence of an increased amount of blasts IHC of sequential biopsies also showed an increasing infiltration with CD3+ T lymphocytes in the first and second biopsy, while at remission, only expected, interstitial and nodular T lymphocytic infiltrates were observed. the marrow biopsy at 96 days contained only <1% apoptotic cells, when at day 1 (<5%) and day 2 (15% apoptotic)
Shichishima et al., 2000⁹³	69 -year-old male	Bone marrowithblood	Lymphocytosis persisted, but the number of lymphocytes gradually decreased over about 2 years without therapy and thereafter remained <5x10^9/L BM aspirate in Feb 1997 showed a normal myelogram, with normal PB cell counts, flow cytometry of BM mononuclear cells showed improvement of the immunophenotype (values in ARTicle) immunological remission including normalization of percentage CD7+ cells and the CD4/8 ratio was confirmed in PB the rearrangement bands of the TCR-beta gene in the PB and/or marrow had decreased or disappeared between September 1996 and May 1998, during this period, the patient remained asymptomatic complete SR about 39 months after diagnosis, which continued	may be due to unusual features of cells i.e. no CD7+ phenotype or chromosome abnormality including structural abnormalities of 14q	Lymphocytosis persisted, but the number of lymphocytes gradually decreased over about 2 years without therapy and thereafter remained <5x10^9/L BM aspirate in Feb 1997 showed a normal myelogram, with normal PB cell counts, flow cytometry of BM mononuclear cells showed improvement of the immunophenotype (values in ARTicle) immunological remission including normalization of percentage CD7+ cells and the CD4/8 ratio was confirmed in PB the rearrangement bands of the TCR-beta gene in the PB and/or marrow had decreased or disappeared between September 1996 and May 1998, during this period, the patient remained asymptomatic complete SR about 39 months after diagnosis, which continued
Van et al., 2004⁹⁴	new born female	Skin	before lab and staging, SR of all lesions was observed after a few weeks, small nodules (up to 3cm diameter) on the soles of both feet came and went during a 3 months period; subsequently, the nodules became purple and disappeared in 2 weeks no new nodules developed after the age of 3.5 months she is now 3.5 years and well	it might be that the anomaly isn't a true leukemia but a derailment similar to TMD might be that the tumor burden is low and is attacked by the immune system possibility that the abnormal cells seen in the neonatal period have not yet acquired full proliferative capacity and still have a very high rate of spontaneous apoptosis suspection of maternal-fetal immune interactions and a role for oncogenes and tumor suppressor genes	before lab and staging, SR of all lesions was observed after a few weeks, small nodules (up to 3cm diameter) on the soles of both feet came and went during a 3 months period; subsequently, the nodules became purple and disappeared in 2 weeks no new nodules developed after the age of 3.5 months she is now 3.5 years and well
Wajima, 2000⁹⁵	77 -year-old male blood type O, Rh+	Bone marrowithblood	during 3 years of follow-up, WBC and lymphocyte counts declined gradually patient responded to prednisone, his Hgb rose to 12.9g/dL, Hct to 38%, and platelets normal limits. WBC increased to 14400/uL with 74% lymphocytes, absolute lymphocyte count was 10700/uL, 18% neutrophils	SR in CLL is suggested to result from an altered host-tumor relationship lymphocyte production may have been under the control of a readjusted hematopoietic mechanism, the CLL in marrow evidently altered stroma function and induced stromal abnormalities that selectively suppressed lymphocyte production and induced anemia and thrombocytopenia, the prednisone altered this autoimmune phenomenon	during 3 years of follow-up, WBC and lymphocyte counts declined gradually patient responded to prednisone, his Hgb rose to 12.9g/dL, Hct to 38%, and platelets normal limits. WBC increased to 14400/uL with 74% lymphocytes, absolute lymphocyte count was 10700/uL, 18% neutrophils
Kiyohara et al., 2000⁹⁶	62 -year-old female September 1993	right thigh, right lower leg, the left thigh, and left lower intravascular	the size of the nodes decreed by about 50% spontaneously in one months and further prior to treatment the nodules completely disappeared and bone marrow exam revealed normcellular marrow and a decrease in atypical cells down to 1.5%, the serum level of LDH decreased to 600 IU/l	regression may be observed in patients with other lymphoproliferative processes no major proposed mechanism…	the size of the nodes decreed by about 50% spontaneously in one months and further prior to treatment the nodules completely disappeared and bone marrow exam revealed normcellular marrow and a decrease in atypical cells down to 1.5%, the serum level of LDH decreased to 600 IU/l
Hosahalli & Asanna et al., 2023⁹⁷	1-month-old male	skin	24 months later, there was only a small visible scar at the biopsy site on his left cheek, and the scalp lesion completely resolved	KAT6A::EP300 fusion has been associated with spontaneous remission.	24 months later, there was only a small visible scar at the biopsy site on his left cheek, and the scalp lesion completely resolved
Helbid, 2020⁹⁸	40-year-old man	bone marrow	While waiting to begin induction chemotherapy, his fevers resolved and his peripheral blood counts improved. A repeat bone marrow biopsy was performed 3 weeks from the original bone marrow biopsy (day 21), revealing a normocellular marrow (60-70%) with trilineage maturing hematopoiesis with no overt increase in blasts. Flow cytometry identified a small abnormal myeloid blast population comprising only 0.08% of the total cells analyzed. A repeat bone marrow was performed a month later (day 49) as an outpatient, which showed a normocellular marrow (50-60%) with trilineage maturing hematopoiesis with no abnormal myeloid blasts identi- fied by flow cytometry	immune-mediated caused secondary to a preceding severe infection	While waiting to begin induction chemotherapy, his fevers resolved and his peripheral blood counts improved. A repeat bone marrow biopsy was performed 3 weeks from the original bone marrow biopsy (day 21), revealing a normocellular marrow (60-70%) with trilineage maturing hematopoiesis with no overt increase in blasts. Flow cytometry identified a small abnormal myeloid blast population comprising only 0.08% of the total cells analyzed. A repeat bone marrow was performed a month later (day 49) as an outpatient, which showed a normocellular marrow (50-60%) with trilineage maturing hematopoiesis with no abnormal myeloid blasts identi- fied by flow cytometry
Edington, 2019⁹⁹	6-month-old African American male infant, born at 27 weeks of gestation	bone marrow	A bone marrow cytogenetic analysis performed 63 months after diagnosis abruptly changed to having 45,XY,-7 in only 2 of 20 cells. One year later (75 mo after initial diagnosis), the patient’s bone marrow biopsy normalized to 46,XY and FISH for monosomy 7 was negative.	none reported	A bone marrow cytogenetic analysis performed 63 months after diagnosis abruptly changed to having 45,XY,-7 in only 2 of 20 cells. One year later (75 mo after initial diagnosis), the patient’s bone marrow biopsy normalized to 46,XY and FISH for monosomy 7 was negative.
Suzuki, 2021¹⁰⁰	85-year-old man, history of cancer of the appendix, which had undergone surgical resection six years previously without chemotherapy or radiotherapy. history of aortic arch aneurysm, for which stent-graft treatment had been performed seven years previously.	bone marrow, blood	2 months later, bone marrow aspiration performed in September showed a decrease in abnormal cells, while the peripheral blood showed no abnormal cells.	probably induced by sepsis	2 months later, bone marrow aspiration performed in September showed a decrease in abnormal cells, while the peripheral blood showed no abnormal cells.
Raza et al., 1985¹⁰¹			As the infection responded, a simultaneous improvement was noted in his hematologic picture as well as a partial remission in the bone marrow	nonspecific stimulation of the immune system by the infection might play a major role in inducing remission	As the infection responded, a simultaneous improvement was noted in his hematologic picture as well as a partial remission in the bone marrow
Schnitzer et al., 8357¹⁰²	A 73-year-old white man from Michigan		spontaneous remission without evidence of residual leukaemia at necropsy		spontaneous remission without evidence of residual leukaemia at necropsy
Han, 1987¹⁰³	The cohort included seven males and four females. Their ages ranged from 37 to 69 years at the time of diagnosis.		Spontaneous remission was observed several years after the diagnosis in seven patients (six with stage 0 and one with stage II disease); five of those are still alive and two have died of unrelated cause. A complete autopsy was carried out on one case and no microscopic evidence of leukemia was found.	Upper respiratory infection was noted prior to the onset of spontaneous remission in 2 of 11 patients with CLL in the present study. Ribera and associates (Blood Cells 12 (1986), 471-479) observed viral infection (varicella zoster) in one case and possible viral infection (bilateral orchitis) in another case among three cases of spontaneous remission. Viral infections also preceded spontaneous remission in two cases reported by others. (Vladimirskaia EB, Problem Gematologii I Perelevaniya Krovi, 7: 1962, 51-54 and Bousser J, Novelle Revue Franchise D’hematologic 5 (1965), 498-601.) In two additional patients, spontaneous remission was related to smallpox vaccination. (Hansen RM, Archives of Internal Medicine 138 (1978), 1137 and Yettra M, Archives of Internal Medicine 139 (1979), 603.) These observations suggest that viral infection may play a role in the induction of spontaneous remission in some cases.	Spontaneous remission was observed several years after the diagnosis in seven patients (six with stage 0 and one with stage II disease); five of those are still alive and two have died of unrelated cause. A complete autopsy was carried out on one case and no microscopic evidence of leukemia was found.
Weintraub et al., 2000¹⁰⁴	7 days/F	Bone marrow	Skin and bone marrow	Not reported	15 months
Hackett & Hallidie-Smith et al., 1984¹⁰⁴	A West Indian girl, 1 year old		systolic thrill had disappeared, no evidence of bounding pulses, systolic thrill, or any continuous murmur, normal electrocardiogram and chest radiograph, no evidence of any left to right shunting, dilated right coronary artery ostium but no fistula was evident		systolic thrill had disappeared, no evidence of bounding pulses, systolic thrill, or any continuous murmur, normal electrocardiogram and chest radiograph, no evidence of any left to right shunting, dilated right coronary artery ostium but no fistula was evident
Chan et al., 1989¹⁰⁵	7-week-old girl		Decrease in the intensity of the murmur, electrocardiogram no longer appeared abnormal, right ventricular systolic pressure of 32 mm Hg, outflow gradient fallen to 14 mmHg, no audible murmurs at the age of eight, normal heart on cross-sectional echocardiography and Doppler ultrasound		Decrease in the intensity of the murmur, electrocardiogram no longer appeared abnormal, right ventricular systolic pressure of 32 mm Hg, outflow gradient fallen to 14 mmHg, no audible murmurs at the age of eight, normal heart on cross-sectional echocardiography and Doppler ultrasound
Labbe et al., 1983¹⁰⁶	A three-year-old girl who had for two months suffered bruising after minimal injury		Although the inhibitor still persisted at high levels after two years, no further haemorrhage occurred, excepted haematomas three months after the onset of symptoms, in association with mumps		Although the inhibitor still persisted at high levels after two years, no further haemorrhage occurred, excepted haematomas three months after the onset of symptoms, in association with mumps
Nakazono et al., 2009¹⁰⁷
¹⁰⁸
Leung et al., 2003¹⁰⁹
Matsuda et al., 2007¹¹⁰
Mylonakis et al., 2008¹¹¹
Parker et al., 2008¹¹²
Petti et al., 2001¹¹³
Prince et al., 2012¹¹⁴
Lou et al., 2011¹¹⁵
Chen et al., 2009¹¹⁶
Tzankov et al., 2001¹¹⁷
Itzep, 2019¹¹⁸
Zhang et al., 2023¹¹⁹
Hao et al., 2019¹²⁰
Yıldız et al., 2019¹²¹
Zhang et al., 2024¹²²
Seo et al., 2018¹²³
Ngu¹²⁴
Gómez García et al.¹²⁵
Maywald et al.¹²⁶
Kaźmierczak et al.¹²⁷
Gyárfás et al.¹²⁸
Höres et al.¹²⁹
Helbig et al.¹³⁰

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