Spontaneous molecular response of IDH2 acute myeloid leukemia

Khalife‐Hachem, Sabine; Pegliasco, Jean; Saada, Véronique; Hernández, E.; Camara-Clayette, Valérie; Cotteret, Sophie; Benabdelali, Raouf; Botton, Stéphane de; Marzac, Christophe; Micol, Jean-Baptiste

doi:10.1007/s00277-019-03876-8

Cited by 2 publications

(1 citation statement)

References 5 publications

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“…Untreated AML patients usually demonstrated a progressive process [1]. However, spontaneous remission occasionally occurred in a very small proportion of untreated AML patients, which frequently followed a febrile episode and antibiotic treatment and was generally attributed to the activation of anti-neoplastic activities [5][6][7][8][9][10][11][12]. This spontaneous remission could occur not only in patients with recurrent cytogenetic abnormalities but also in patients with gene mutations in transcription factors.…”

Section: Introductionmentioning

confidence: 99%

Glucocorticoid and Antibiotic Treatment-induced Recapitulated Hematological Remissions in Acute Myeloid Leukemia: Implications for Ligand-dependent Growth and Survival Advantage

Sun¹,

Xiao

Yang³

et al. 2021

Preprint

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Leukemia-transformed multipotential hematopoietic cells have acquired the increased self-renewal capacity and impaired myeloid differentiation to mature blood cells. The emergence of symptomatic leukemia also critically requires the acquisition of growth and survival advantage in leukemic cells. Untreated leukemia patients usually demonstrated a progressive process. However, spontaneous remission occasionally occurred in a very small number of leukemia patients, which frequently followed a febrile episode and antibiotic treatment and was generally attributed to the activation of anti-neoplastic activities. Here we report a 63-year-old Chinese man who presented with the main complaints of abdominal pain, febrile episode and urticaria-like skin lesions. He was diagnosed with acute myeloid leukemia (AML-M4) with t(8;21)(q22;q22)/RUNX1-RUNX1T1 on the basis of morphological, immunological, cytogenetic and molecular analysis. He also had a mutated FLT3-TKD gene. He was treated with antibiotics and glucocorticoid for the gastrointestinal infection and the urticaria-like skin lesions. The infection and skin lesions were quickly resolved. Unexpectedly, along with the relief of the febrile episode, abdominal symptoms and skin lesions, he achieved a hematological remission. After relapse, repeating this treatment resulted in the second hematological remission. These recapitulated treatment responses strongly suggested that inflammatory stresses arising from the gut inflammatory lesions, which could be largely mitigated by antibiotic and glucocorticoid treatment, sustained the growth and survival advantage of the leukemic cells.

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Section: Introductionmentioning

confidence: 99%

Glucocorticoid and Antibiotic Treatment-induced Recapitulated Hematological Remissions in Acute Myeloid Leukemia: Implications for Ligand-dependent Growth and Survival Advantage

Sun¹,

Xiao

Yang³

et al. 2021

Preprint

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Antibiotic and glucocorticoid-induced recapitulated hematological remission in acute myeloid leukemia: A case report and review of literature

Sun¹,

Yang²,

Yang³

et al. 2022

WJCC

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BACKGROUND Leukemic hematopoietic cells acquire enhanced self-renewal capacity and impaired differentiation. The emergence of symptomatic leukemia also requires the acquisition of a clonal proliferative advantage. Untreated leukemia patients usually experience an aggressive process. However, spontaneous remission occasionally occurs in patients with acute myeloid leukemia (AML), most frequently after recovery from a febrile episode, and this is generally attributed to the triggering of antineoplastic immunity. There may be another explanation for the spontaneous remission as implicated in this paper. CASE SUMMARY A 63-year-old Chinese man presented with high fever, abdominal pain and urticaria-like skin lesions. He was diagnosed with AML-M4 with t(8;21) (q22;q22)/RUNX1-RUNX1T1 based on morphological, immunological, cytogenetic and molecular analyses. He had a complex chromosome rea-rrangement of 48,XY,t(8;21)(q22;q22),+13,+13[9]/49,idem,+mar[9]/49,idem,+8[2]. He also had a mutated tyrosine kinase domain in fms-like tyrosine kinase 3 gene. He was treated with antibiotics and glucocorticoids for gastrointestinal infection and urticaria-like skin lesions. The infection and skin lesions were quickly resolved. Unexpectedly, he achieved hematological remission along with resolution of the febrile episode, gastrointestinal symptoms and skin lesions. Notably, after relapse, repeating these treatments resulted in a return to hematological remission. Unfortunately, he demonstrated strong resistance to antibiotic and glucocorticoid treatment after the second relapse and died of sepsis from bacterial infection with multidrug resistance. The main clinical feature of this patient was that symptomatic AML emerged with flaring of the gut inflammatory disorder and it subsided after resolution of the inflammation. Learning from the present case raises the possibility that in a subgroup of AML patients, the proliferative advantage of leukemia cells may critically require the presence of inflammatory stresses. CONCLUSION Inflammatory stresses, most likely arising from gastrointestinal infection, may sustain the growth and survival advantage of leukemic cells.

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Spontaneous molecular response of IDH2 acute myeloid leukemia

Cited by 2 publications

References 5 publications

Glucocorticoid and Antibiotic Treatment-induced Recapitulated Hematological Remissions in Acute Myeloid Leukemia: Implications for Ligand-dependent Growth and Survival Advantage

Glucocorticoid and Antibiotic Treatment-induced Recapitulated Hematological Remissions in Acute Myeloid Leukemia: Implications for Ligand-dependent Growth and Survival Advantage

Antibiotic and glucocorticoid-induced recapitulated hematological remission in acute myeloid leukemia: A case report and review of literature

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