Fozza C, Bellizzi S, Bonfigli S, Campus P M, Dore F, Longinotti M
Institute of Hematology, University of Sassari, Italy.
Eur J Haematol. 2004 Sep;73(3):219-22. doi: 10.1111/j.1600-0609.2004.00281.x.
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.
迄今为止,已有数例未经治疗的急性髓系白血病(AML)自发缓解(SR)中断其必然进展病程的报道。我们将在此系列中补充一例发生在一名72岁患骨髓增生异常综合征后并发AML男性患者身上的血液学和细胞遗传学自发缓解病例。诊断时细胞遗传学分析显示核型为48,xy,del(6)(p22 - pter),+13,+14。由于大叶性肺炎,化疗推迟并采用了广谱抗生素治疗。支持性治疗包括输注红细胞和血小板以及低剂量皮质类固醇。两个月后,肺炎完全消失,尽管仍存在一定程度的髓系发育异常,但骨髓形态学和细胞遗传学检查记录到完全缓解持续了约5个月。本文结合文献综述讨论了AML病程中所描述的各种自发缓解的可能机制。