Bone Marrow Transplantation Center, The First Affiliated Hospital of Zhejiang University, 79 Qingchun Road, Hangzhou, 310003, China.
Med Oncol. 2012 Dec;29(4):2417-22. doi: 10.1007/s12032-012-0215-y. Epub 2012 Apr 3.
Spontaneous remission of acute myeloid leukemia (AML) is an extremely uncommon event. The etiology is associated with infection, blood transfusion or granulocyte colony-stimulating factor therapy, which trigger immune responses to exert an antileukemic effect. The remission is usually temporary and followed by rapid relapse. However, we present a case of a 42-year-old man with spontaneous remission of AML-M5a, who did not relapse but developed a rare and aggressive lymphoma, named cutaneous blastic plasmacytoid dendritic cell neoplasm (BPDCN). The neoplasm cells are positive for CD4, CD56, CD43, CD45, and CD123, but negative for other lineage-specific markers. To our knowledge, this is the first report of BPDCN occurring after spontaneous remission of AML, although it has been observed that some BPDCN could shift to myeloid leukemia. Occurrence of the two diseases is more than a coincidence. Discovery of such cases may shed further light on the inner connection between BPDCN and myeloid disorders.
急性髓系白血病(AML)的自发缓解是一种极其罕见的事件。其病因与感染、输血或粒细胞集落刺激因子治疗有关,这些因素引发免疫反应,发挥抗白血病作用。缓解通常是暂时的,随后迅速复发。然而,我们报告了一例 42 岁男性 AML-M5a 的自发缓解病例,该患者未复发,但发展为一种罕见且侵袭性的淋巴瘤,称为皮肤原始浆细胞样树突细胞肿瘤(BPDCN)。肿瘤细胞阳性表达 CD4、CD56、CD43、CD45 和 CD123,但阴性表达其他谱系特异性标志物。据我们所知,这是 AML 自发缓解后发生 BPDCN 的首例报告,尽管已经观察到一些 BPDCN 可能向髓系白血病转化。两种疾病的发生不仅仅是巧合。发现此类病例可能进一步揭示 BPDCN 与髓系疾病之间的内在联系。