Cytogenetic and hematological spontaneous remission in a case of acute myelogenous leukemia

Abstract

Several cases of spontaneous remission (SR) interrupting the invariably progressive course of untreated acute myeloblastic leukemia (AML) have been reported so far. We shall add to this series the hematological and cytogenetic SR occurring in a 72-yr-old man affected by AML following myelodysplastic syndrome. At diagnosis cytogenetic analysis showed the 48, xy, del (6) (p22-pter), +13, +14 karyotype. Owing to a lobar pneumonia, the chemotherapy was deferred and a broad spectrum antibiotic therapy was established. Supportive care included red cells and platelet transfusions and low-dose corticosteroid. Two months later, after the pneumonia had completely disappeared, a complete remission, lasting about 5 months, was documented on bone marrow morphological and cytogenetical examination, although some degree of myeloid dysplasia persisted. Possible mechanisms of the various SRs described during the course of AML are discussed with a review of the literature.

An unusual case of smoldering AML with prolonged indolent clinical course and spontaneous remission in the terminal phase

“…There are about 20 reports of spontaneous remission of AML since the 1980s [7][8][9][10][11][12][13][14][15]. Spontaneous remission is by no means synonymous with cure, since the average duration of the remission is only 7.1 ± 9.2 months [7].…”

Spontaneous hematological remission of acute myeloid leukemia

“…Between 1979 and 2008 about thirty patients were described manifesting SR of AML. The median duration of remission was generally short (the mean was about 6 months); however, even long-term and complete cytogenetic remissions were documented [9, 10]. …”

Lorenz system in the thermodynamic modelling of leukaemia malignancy

“…Spontaneous remission of acute myeloid leukaemia is almost always a transient event, with a mean duration in the literature of 7.7 months (range 1-36) [23]. In a typical case of spontaneous remission, the full restoration of normal haematopoiesis and the disappearance of blast cells occur in patients with acute leukaemia and concurrent infection [23][24][25][26][27][28][29][30][31][32][33][34], blood transfusion [23][24][25]31,35] or cytokine injection [36,37]. The underlying molecular mechanisms of spontaneous remission are still unknown.…”