Spontaneous Remission In Acute Myelogenous Leukemia Evidenced By Cytogenetic Changes
Teng, C. J., Yang, C. F., Gau, J. P., Liu, J. H., Hong, Y. C., Liu, C. Y., Yu, Y. B., Hsiao, L. T., Wang, W. S., & Tzeng, C. H. (2011). spontaneous remission in acute myelogenous leukemia evidenced by cytogenetic changes. Annals of hematology, 90(8), 981–983. https://doi.org/10.1007/s00277-010-1120-0
View Original Source →Case Details
Disease Location
Bone marrowithblood
Personal Characteristics
75 -year-old male taiwanese
Clinical Characteristics
Presented with 4 day history of fever and productive cough on admission, blood routine showed pancytopenia. Chest x-ray film revealed consolidative patches in bilateral lower lung fields antibiotics were used to treat pneumonia, blood component therapy was given for correcting anemia and thrombocytopenia bone marrow study showed a markedly hypercellular marrow with over 90% myeloblasts, while a conventional cytogenetic study revealed an abnormal clone: trisomy 8, in 20 cultured cells 4 months after the sr achievement, a progressive decline in the neutrophil and platelet counts was observed bone marrow study performed 21 weeks after sr showed a hypocellular marrow with predominant myeloblasts (~90%), indicating a relapse of disease concomitant cytogenetic study showed reemergence of the leukemic clone, trisomy 8 in 20 metaphase cells the patient denied induction chemo and he died of the disease 4 weeks later, 26 weeks after initial diagnosis
Remission Characteristics
25 days after admission, hemogram unexpectedly began to improve with gradually rising levels of neutrophil and platelet, concomitant with the improvement in the clinical condition and the resolution of fever and pulmonary consolidation in the chest x-ray follow-up bone marrow study 4 weeks later after initial diagnosis showed a hypocellular marrow with adequate megakaryocytes and absence of leukemic blasts the chromosomal abnormality of trisomy 8 was not observed in the only two metaphase cells noted repeated bone moarrow study 7 weeks after initial diagnosis confirmed the complete remission, the cytogenetic study also confirmed the disappearance of clonal chromosomal abnormalities in 10 metaphase cells
Treatment & Mechanisms
Proposed Remission Mechanisms
The scanty of cells in metaphases in this case was probably related to inadequate recovery of the suppressed normal hematopoisesis after elimination of the leukemia remission may result from suppression of the leukemia clone rather than clonal remission with differentiation of the leukemic cells in many cases, cytogenetic remission occurred after episodes of pneumonia or severe sepsis, implying that suppressing leukemic cells can be induced it is likely that the development of leukemia-inhibitory factor(s) was a transient phenomenon that rapidly faded out (e.g. Tumor necrosis factor-alpha, interleukin-2 and interferon-lambda are known to increase during severe sepsis and are all showed antileukemic effects)
Clinical Treatment
Antibiotics, blood component therapy
Non-Clinical Treatment
None reported