Adam M, Eltayeb A
Dr. Muna Adam, MBBS, MRCP (UK), Teaching assistant, Oncology Department, National Cancer Institute, University of Gezira, Wadmedani, Sudan. Email:
National Cancer Institute, University of Gezira, Wadmedani, Sudan.
Gulf J Oncolog. 2014 Jan;1(15):84-6.
Spontaneous remission of Acute Myeloid leukaemia (AML) is an uncommon event, temporary and its mechanism is yet to be determined. We report here a case of spontaneous remission of AML in a 35 years old male who was diagnosed with AML (M4) in Jan 2011. He presented very ill with fever, bleeding tendency and oral candidacies. He received supportive care only and chemotherapy was withheld. His general condition improved and fever subsided. White blood cell (WBC) count started to drop spontaneously and gradually until he became leukopenic and developed febrile neutropenia. After the second recovery, his full blood count (FBC) and bone marrow examination showed haematological remission. He was followed up for six weeks after which relapse occurred. Chemotherapy was started immediately, but unfortunately was not continued because of sepsis. The patient died four weeks after relapse. Other reports on the spontaneous remission of AML showed a similar temporary period of remission with different duration, and then followed by relapse. Possible mechanisms of spontaneous remission in AML are discussed with a review of the literature.
Acute myeloid leukemia, spontaneous remission.
急性髓系白血病(AML)的自发缓解是一种罕见、暂时的现象,其机制尚待确定。我们在此报告一例35岁男性AML自发缓解的病例,该患者于2011年1月被诊断为AML(M4)。他就诊时病情严重,有发热、出血倾向和口腔念珠菌病。他仅接受了支持治疗,未进行化疗。他的一般状况有所改善,发热消退。白细胞(WBC)计数开始自发且逐渐下降,直至出现白细胞减少并发展为发热性中性粒细胞减少。第二次恢复后,他的全血细胞计数(FBC)和骨髓检查显示血液学缓解。他接受了六周的随访,之后复发。立即开始化疗,但不幸的是由于败血症未能继续进行。患者在复发四周后死亡。其他关于AML自发缓解的报告显示了类似的不同持续时间的暂时缓解期,随后复发。本文结合文献综述讨论了AML自发缓解的可能机制。
急性髓系白血病,自发缓解