Nakamura N, Mori M, Kimizima K
Rinsho Ketsueki. 1989 Oct;30(10):1835-9.
A spontaneous complete remission of 5 month's duration was observed in a 70 year-old man with acute myeloblastic leukemia complicated with severe pneumonia. The remission occurred after severe pancytopenia. He was treated only with antibiotics and blood transfusions. On admission, the leukocyte count was 6.4 x 10(3)/microliters with 98% myeloblasts. The hemoglobin level was 9.9 g/dl and platelet count was 1.5 x 10(4)/microliters. Marrow aspirate was hypercellular with 98.5% myeloblasts, which weakly showed Ia like antigen and myeloid related antigen. On relapse after five weeks' complete remission, leukemic cells were more immature, peroxidase negative and showed no surface markers. Chromosomal abnormalities were detected. During remission induction therapy he died of severe bacterial and fungal sepsis. Such cases of spontaneous complete remission have been rarely reported, previous adult cases were summarized and the role of etiologic factors were discussed.
一名70岁急性髓细胞白血病合并严重肺炎的男性患者出现了持续5个月的自发完全缓解。缓解发生在严重全血细胞减少之后。他仅接受了抗生素治疗和输血。入院时，白细胞计数为6.4×10³/微升，原始粒细胞占98%。血红蛋白水平为9.9克/分升，血小板计数为1.5×10⁴/微升。骨髓穿刺显示细胞增多，原始粒细胞占98.5%，弱阳性表达Ia样抗原和髓系相关抗原。在完全缓解五周后复发时，白血病细胞更加不成熟，过氧化物酶阴性，且无表面标志物。检测到染色体异常。在缓解诱导治疗期间，他死于严重的细菌和真菌败血症。这种自发完全缓解的病例鲜有报道，对既往成人病例进行了总结并讨论了病因因素的作用。
