Spontaneous Remission of Acute Myeloid Leukemia – a Single Center Case Reports

Česká verzia

Authors: M. Pachner; S. Vokurka; V. Koza; T. Svoboda; M. Hrabětová; P. Jindra; D. Lysák; V. Vozobulová; M. Schutzova; M. Karas
Authors place of work: Hematologicko-onkologické oddělení, FN Plzeň
Published in the journal: Klin Onkol 2013; 26(2): 140-142
Category: Kazuistika

Summary

Background:
Acute myeloid leukemia is a malignant disease characterized by clonal expansion of immature hematopoietic cells – myeloblasts – in the bone marrow. Intensive chemotherapy treatment in elderly patients (over 60) has disappointing results. In these patients, conservative treatment, including compensation of deficiency of red blood cells and platelets by transfusions and treatment of infectious complications is recommended. Also, relatively new treatment with hypometyl agents (azacytidine, decitabine) could be used.

Design:
The idea of this article is to present a ‘spontaneous remission’ phenomenon, which has not been published in Czech literature yet. In this article, we present 2 case studies of our patients who were diagnosed with acute myeloid leukemia, were not treated with chemotherapy and spontaneously reached remission of acute myeloid leukemia.

Conclusion:
The mechanisms of the spontaneous remission remain unclear, but we assume positive effect of a severe systemic infection or previous applications of blood transfusions. Antibodies in blood transfusions and a strong immune response to sepsis may have contributed to spontaneous remission.

Key words:
spontaneous remission – acute myeloid leukemia – sepsis – infection – cytology – erythrocyte transfusion – cytogenetics

Zdroje

1. Swerdlow SH, Campo E, Lee Harris NL et al (eds). WHO Classification of Tumours of Haematopoietic and Lymphoid Tissue. Lyon, France: IARC 2008: 111–147.

2. Adam Z, Krejčí M, Vorlíček J et al (eds). Hematologie, přehled maligních hematologických nemocí. 2. vyd. Praha: Grada 2008: 29–37.

3. Češka R, Tesař V, Dítě P et al (eds). Interna. 1. vyd. Praha: Triton 2010.

4. Fozza C, Bellizzi S, Bonfigli S et al. Cytogenetic and hematological spontaneous remission in a case of acute myelogenous leukemia. Eur J Haematol 2004; 73(3): 219–222.

5. Trof RJ, Beishuizen A, Wondergem MJ et al. Spontaneous remission of acute myeloid leukaemia after recovery from sepsis. Neth J Med 2007; 65(7): 259–261.

6. Tsukada T, Kobayashi K, Otsuji N et al. Spontaneous transient remission in adult acute myeloid leukemia. Rinsho Ketsueki 1989; 30(2): 227–231.

7. Spadea A, Latagliata R, Martinelli E et al. Transient spontaneous remission in a case of adult acute myelogenous leukemia. Br J Haematol 1990; 76(1): 154.

8. Paul R, Remes K, Lakkala T et al. Spontaneous remission in acute myeloid leukemia. Br J Haematol 1994; 86(1): 210–212.

9. Eisenlohr C. Leuaemia lienalis: Lymphatic and medularis mit multiplen Gehirnnervenlähmungen. Vircows Arch A 1878; 73: 56–73.

10. Maywald O, Buchheidt D, Bergman J et al. Spontaneous remission in adult acute myeloid leukemia in association with systemic bacterial infection – case report and review of the literature. Ann Hematol 2004; 83(3): 189–193.