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Spontaneous Clinical Regression In Chronic Lymphocytic Leukaemia

Thomas et al., 2002Leukemia

Thomas, R., Ribeiro, I., Shepherd, P., Johnson, P., Cook, M., Lakhani, A., Kaczmarski, R., Carrington, P., & Catovsky, D. (2002). spontaneous clinical regression in chronic lymphocytic leukaemia. British journal of haematology, 116(2), 341–345. https://doi.org/10.1046/j.0007-1048.2001.03286.x

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Abstract

. Chronic lymphocytic leukaemia (CLL) is a B‐cell disorder, which has a median survival of over 10 years from diagnosis for stage A disease. The natural history of stage A disease is generally indolent or only slowly progressive. It is less well known that CLL may undergo spontaneous regression. We report a series of 10 such cases (eight stage A and two stage B) followed at our institutions.

Case Details

Disease Location

Bone marrowithblood/ln

Personal Characteristics

60 -year-old female she was noted to have small volume left cervical and axillary nodes since 1985 which remained stable in size over the period till presentation

Clinical Characteristics

Presented in 1993 with a 9-year history of recurrent attacks of toxoplasmosis at presentation she was found to have monoclonal b lymphocytosis lymph node biopsy was consistent with a low-grade b-cell lymphocytic lymphoma since her diagnosis of cll, she continued to have recurrent toxoplasmosis which she received intermittent ciprofloxacin during follow up she developed larger bilateral cervical and axillary lymph nodes, the largest measuring 2x1cm

Remission Characteristics

The lymph nodes subsequently disappeared on clinical exam but the lymphocyte count gradually decreased reaching 1.1x10^9/l in july 1998 immunophenotyping at this time revealed most lymphocytes to be t cells (CD2 87%) and only 4% expressed CD5/19 positivity

Treatment & Mechanisms

Proposed Remission Mechanisms

Possibility of a natural regulatory mechanism controlling b-cell cll, which in rare instances leads to a downregulation of cell proliferation and eventually to a durable clinical remission

Clinical Treatment

Ciprofloxacin

Non-Clinical Treatment

None reported