Fan W J, Xu T T, Sang L N, Guo J J, Li Y F, Pei Z X, Jiang Z X
Department of Hematology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, China.
Department of Blood Transfusion, Henan Provincial People's Hospital, Zhengzhou 450000, China.
Zhonghua Xue Ye Xue Za Zhi. 2021 Oct 14;42(10):851-857. doi: 10.3760/cma.j.issn.0253-2727.2021.10.010.
To explore the clinical features and possible pathogenesis of spontaneous remission of acute myeloid leukemia (AML) . We retrospectively analyzed the clinical data of a patient with spontaneous remission of AML, MLL-AF9 rearrangement, and abnormal liver function in the First Affiliated Hospital of Zhengzhou University, and the relevant pieces of literature were summarized. The patient experienced lung infection, fever, and liver dysfunction and was treated with anti-infection and blood transfusion. After complete response (CR) , the patient remained in CR with mild, indirect bilirubin elevation at 35 months of follow-up. Additionally, 56 cases of adult AML (non-acute promyelocytic leukemia) were reported in the literature from 1990 to June 2021. The cases were checked by bone marrow aspiration, and our patients were summarized and analyzed. Furthermore, 57 patients, including 37 males and 20 females, with a median age of 51 (20-83) years and a median remission time of five months; 52 patients achieved complete remission. In addition, there were five cases with long-term remission and a chromosomal record, with no recurrence so far, three with normal karyotype and two with t (9;11) (q21;q23) . The spontaneous remission of leukemia is rare and may be related to immunosuppression and genes.
为探讨急性髓系白血病（AML）自发缓解的临床特征及可能的发病机制。我们回顾性分析了郑州大学第一附属医院1例AML自发缓解、伴有MLL-AF9重排及肝功能异常患者的临床资料，并对相关文献进行总结。该患者出现肺部感染、发热及肝功能异常，接受抗感染及输血治疗。完全缓解（CR）后，随访35个月，患者仍处于CR状态，间接胆红素轻度升高。此外，检索1990年至2021年6月的文献，共报道56例成人AML（非急性早幼粒细胞白血病）病例。这些病例均经骨髓穿刺检查，对病例进行总结分析。另外，57例患者，其中男性37例，女性20例，中位年龄51（20 - 83）岁，中位缓解时间5个月；52例患者达到完全缓解。此外，有5例长期缓解且有染色体记录，目前无复发，3例核型正常，2例为t（9；11）（q21；q23）。白血病自发缓解较为罕见，可能与免疫抑制及基因有关。
