Spontaneous Remission Of Adult Acute Lymphoblastic Leukemia: A Very Rare Event
Purohit, A., Aggarwal, M., Kumar, S., Seth, T., Mishra, P., Mahapatra, M., Saxena, R., Sharma, R., Singh, P. K., & Venkateshan, S. (2015). spontaneous remission of adult acute lymphoblastic leukemia: a very rare event. Indian journal of hematology & blood transfusion : an official journal of Indian Society of Hematology and Blood Transfusion, 31(1), 159–160. https://doi.org/10.1007/s12288-014-0351-y
View Original Source →Abstract
A middle aged male presented to us with an unusual problem when his acute lymphoblastic leukemia (ALL) disappeared without any chemotherapy. We faced a dilemma whether to go ahead and treat his initial diagnosis or wait. Eventually he did relapse and was treated, albeit with a fatal outcome. Such spontaneous remission in acute leukemia are a very rare event, more common in acute myeloid leukemia and in children. Spontaneous remission in adult ALL is rarely described in literature.
Case Details
Disease Location
Blood
Personal Characteristics
46 year old male
Clinical Characteristics
Fever, breathlessness and dry cough of 2 weeks duration. Pancytopenic (hemoglobin 910 gm/l, platelet count 1.1 9 109/l and leucocyte count 1.0 9 109/l with 20 % blasts). The blood culture grew acinetobacter spp. Echocardiography showed a concentrically hypertrophied left ventricle with an 8 9 9 mm sized vegetation on a bicuspid, thickened, calcified aortic valve with moderate stenosis and mild regurgitation. CT of chest showed multiple nodules with a ground glass haze. Bone marrow aspirate with flow-cytometry revealed 90 % blasts of b lineage
Remission Characteristics
After 2 weeks of broad-spectrum antibiotics and antifungals his blood counts normalized and blasts disappeared from peripheral blood. A repeat bone marrow aspirate and biopsy was also normal
Treatment & Mechanisms
Proposed Remission Mechanisms
Not discussed
Clinical Treatment
Cefaperazone + sulbactum, gentamicin and vancomycin, voriconazole and caspofungin