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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

57 -year-old male

Clinical Characteristics

In 1988, routine blood work revealed a lymphocyte count of 25x10^9/l marrow aspirate showed increased cellularity and a diffuse infiltration of lymphocytes the next year, he developed palpable splenomegaly that progressed over the next 5 years to being palpable 8cm below the costal margin lymphocyte count remained stable at 17x10^9/l

Remission Characteristics

Over the next 12 years his lymphocyte and spleen size decreased and when last seen, the spleen was not palpable and he had a lymphocyte count of 3.4x10^9/l immunophenotyping however still showed the persistence of a small clone of CD19/5 positive cells

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