Spontaneous Remission Of Large Granular Lymphocytic Leukaemia
Sosin, M. D., & Handa, S. I. (2003). spontaneous remission of large granular lymphocytic leukaemia. International journal of clinical practice, 57(6), 551–552. https://doi.org/10.1111/j.1742-1241.2003.tb10552.x
View Original Source →Abstract
The phenomenon of spontaneous remission is one of the less well known aspects of the leukaemias. Spontaneous remission has been reported in both acute and chronic leukaemia. The mechanism is unclear but may involve immune modulation related to an intercurrent infection or transfusion of blood products. We present a rare case of spontaneous complete remission of T-cell large granular lymphocytic (T-LGL) leukaemia occurring in an 82-year-old man. The patient died two years later of an unrelated condition, with no evidence of recurrence of T-LGL leukaemia. Elucidation of the mechanism of the phenomenon of spontaneous remission may lead to advances in the treatment of this diverse group of disorders.
Case Details
Disease Location
Blood
Personal Characteristics
82 -year-old male
Clinical Characteristics
Presented in may 1997 after a cbc revealed lymphocytosis, neutropenia, thrombocytopenia and mild anemia physical revealed a palpable spleen tip diagnosis of lymphoproliferative disorder was made peripheral blood studies revealed that the lymphocytes were CD8 positive t cells which were also postive for CD3 and 57, 14% expressed CD16 t-lgl leukemia diagnosis was confirmed (reactive lgl proliferation cannot be completely excluded) in feb 1998, he was admitted with cellulitis affecting both legs and campylobacter gastroenteritis he was treated with IV benzylpenicillin and flucloxacillin followed by oral ciprofloxacin patient eventually died from an unrelated condition with no evidence of relapse of leukemia
Remission Characteristics
Patient made a full recovery after treatment was given in feb 1999, his neutrophil count was rising and over the next year, all hematological indices returned to normal after an 18 months follow up, all blood counts were within normal ranges repeat peripheral blood studies revealed normal b and t cells with no evidence of the t-lgl leukemia clone, confirmed by t-cell receptor gene rearrangement studies as well
Treatment & Mechanisms
Proposed Remission Mechanisms
No major mechanism proposed there is mention of infection in previous cases and the current case's infection, although his infection occurred 12 months before the first evidence of remission
Clinical Treatment
IV benzylpenicillin and flucloxacillin follwed by oral ciprofloxacin
Non-Clinical Treatment
None reported