Spontaneous Remission in an Older Patient with Relapsed ITD Mutant AML.

Spontaneous remission (SR) of acute myeloid leukemia (AML) is a very rare phenomenon. AML characterized by internal tandem duplication ( ITD) is typically associated with an aggressive clinical course with rapid progression, relapse, and short overall survival in the absence of transplantation. We report here the first case of SR of ITD mutant AML in the literature. Our patient was an elderly woman with relapsed and ITD mutant AML whose disease underwent SR for a brief duration without precipitating cause. We review the potential immune mechanisms underlying SR in AML and discuss the implications for novel immunotherapeutic approaches for mutant AML.