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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

69 -year-old male

Clinical Characteristics

Presented with stage a cll in march 1996 with a total lymphocyte count of 81x10^9/l he had a few 2-3cm ln in the left cervical region and both axillae marrow revealed 80% lymphoid infiltration

Remission Characteristics

Over time at his last visit, peripheral counts fell spontaneously to a lowest count of 2.5x10^9/l with diminishing lymphadenopathy repeat bone marrow in july 1999 showed evidence of persisting cll with 25% CD5/19 positive cells and trephine continue to show interstitial infiltration, but the infiltrate in the marrow and trephine had both markedly decreased most recently his peripheral count revealed lymphocytes 84% t cells and only 20% of b cells expressed CD5 and 19

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

None reported

Non-Clinical Treatment

None reported