Spontaneous Remission in Acute Myelogenous Leukemia in the Adult

Abstract

This report describes a patient with bone marrow necrosis associated with a haematological malignancy: chronic lymphocytic leukaemia (CLL). Remarkably, our patient showed clinical and haematological recovery which is maintained more than 2 years later.

Case Details

Personal Characteristics

67-year-old woman, past medical history of cervical carcinoma treated by hysterectomy without radiotherapy in 1948

Clinical Characteristics

Anemia, pneumonia in the lower lobe of the right lung, a palpable spleen tip, diffuse petechiae and ecchymoses, moderate ankle edema, total bilirubin was 6.0 mg/dl with an indirect bilirubin of 2.9 mg/dl, serum glutamic oxalacetic transaminase was 58 iu, pleural effusion, persistent upper respiratory tract infection

Remission Characteristics

Resolution of all clinical and morphologic abnormalities, complete resolution of the infiltrates in the lower lobe of the right lung

Treatment & Mechanisms

Proposed Remission Mechanisms

The remission was apparently associated with an acute pulmonary infection

Clinical Treatment

Halotestin, 15 mg/day, blood transfusions, cephazolin and gentamicin, diphenhydramine, acetaminophen, digoxin, thiazide diuretics, ampicillin, cephalexin, induction chemotherapy for acute myelogenous leukemia, according to caleb protocol #7721, cytosine arabinoside, 100 mg/m2/24 hours by continuous intravenous infusion for seven days, and daunorubicin, 45 mg/m2 by rapid intravenous injection daily for three days

Additional Notes

The patient is in complete remission 19 months after starting induction chemotherapy. Monthly marrow examinations have consistently shown M1 marrow status. The most recent bone marrow was July 11, 1979.