Spontaneous Complete Remission of CLL; Report of a Case Studied with Monoclonal Antibodies

Abstract

The authors describe a case with antibodies to human T-cell lymphoma virus (HTLV) in which there was spontaneous remission without evidence of residual leukaemia at necropsy.

Case Details

Personal Characteristics

76-year-old woman

Clinical Characteristics

Enlarged lymph nodes, white cell count was 10.3 x 109/l with 22% neutrophil, 3% eosinophil, 75% lymphocytes, bone marrow aspirate revealed a sharp increase in the percentage of lymphocytes (91%), lymphography showed enlarged iliac and lumboaortic lymph nodes bilaterally with a lacy appearance typical of lymphoma

Remission Characteristics

Gradual and more and more striking regression of the lymphadenopathies, white cell count was 4.2 x 109/l with 60% lymphocytes, bone marrow aspirate disclosed 21% of lymphocytes, lymphadenopathies were disappeared, bone marrow biopsy showed that the structure of the bone was normal

Treatment & Mechanisms

Proposed Remission Mechanisms

The cause of the remission and its possible connection with the imbalanced distribution of the t lymphocytic subsets is discussed

Clinical Treatment

No chemotherapy was started

Additional Notes

Despite the complete remission, the study of the peripheral blood T lymphocytic subsets by the aid of monoclonal antibodies has showed, however, that the ratio between helper-induced and suppressor cytotoxic T cells is still impaired (0.81) as we can see in overt B-CLL