Adult T-cell Leukaemia With Spontaneous Remission
Lancet 2(8357): Oct 29 1983; 1030
View Original Source →Abstract
Between 1967 and 1979 the authors observed 56 cases of hairy cell leukemia (HCL). Twenty patients are still alive and five of them are in good health over ten years after diagnosis. Two out of these five patients never received any specific treatment. The aim of this communication is to report these two cases of spontaneous remission in HCL.
Case Details
Personal Characteristics
A 73-year-old white man from michigan
Clinical Characteristics
Altered mental status, enlarged inguinal lymph nodes, serum calcium of 17.1 mg/dl, white blood cell (wcc) count of 20,400 x 109/l with 44% lymphocytes, 75% of lymphocytes had multilobulated nuclei, less than 10% abnormal lymphocytes in a bone marrow smear, skin lesions were absent, wcc fell to 20 400 x 109/l with 80% lymphocytes, more than 80% of peripheral blood lymphocytes had the phenotype t11+, t3+, t4, t10+, 70% of these cells were t4+ (helper/inducer) and 26% were t8+ (suppressor/cytotoxic), 33% of lymphocytes were tac+ and all of these cells bore the t4 antigen, none of the t8+ cells were tac+, presence of multilobulated lymphocytes in pleural and abdominal fluids, scattered lymphocytes with lobulated nuclei in lymph nodes, scalloping of trabecular bone with increased osteoclasts
Remission Characteristics
Spontaneous remission without evidence of residual leukaemia at necropsy
Treatment & Mechanisms
Proposed Remission Mechanisms
Not discussed
Clinical Treatment
Hydration and steroid therapy
Additional Notes
The cause of death (6 weeks after onset of illness) was cytomegalovirus pneumonia. No evidence of neoplasm was present post mortem despite the fact that no chemotherapy had been given.