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Imataki O, Ishida T, Kida JI, Uemura M, Fujita H, Kadowaki N. Repeated spontaneous remission of acute myeloid leukemia in response to various infections: a case report. BMC Infect Dis 2023; 23:215. [PMID: 37024850 PMCID: PMC10080930 DOI: 10.1186/s12879-023-08108-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Accepted: 02/20/2023] [Indexed: 04/08/2023] Open
Abstract
BACKGROUND Acute myeloid leukemia (AML) is a progressive hematological malignancy that can be fatal when left untreated. However, spontaneous remission is rarely observed in the presence of infectious diseases. CASE PRESENTATION We treated an 80-year-old woman with AML who spontaneously underwent remission after infections. Spontaneous remission was observed after each of three independent clinical infections caused by different pathogens-nontuberculous Mycobacterium infection, pulmonary aspergillosis, and Escherichia coli bacteremia. All infections were treated promptly with antimicrobials. Mycobacterium avium infection was treated with azithromycin, rifampin, and ethambutol. Pulmonary aspergillosis was treated with itraconazole followed by voriconazole. E. coli infection was treated with meropenem. During each infectious episode, leukemic cells disappeared from the patient's peripheral blood and pancytopenia improved without routine blood transfusion. These clinical effects lasted for several months. The patient has survived for > 2 years beyond the median survival time of end-stage AML. Thus, this case represents an immunological antileukemic effect of systemic infections. CONCLUSIONS We have discussed a common mechanism of spontaneous remission of AML without chemotherapy, clinically exhibited by infection immunology. We believe that infections exert a limited immunological effect against AML, which may prolong survival among elderly individuals with AML.
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Affiliation(s)
- Osamu Imataki
- Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Kagawa University, 1750-1 Ikenobe, Miki-town, Kita-county, Kagawa, 761-0793, Japan.
| | - Tomoya Ishida
- Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Kagawa University, 1750-1 Ikenobe, Miki-town, Kita-county, Kagawa, 761-0793, Japan
| | - Jun-Ichiro Kida
- Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Kagawa University, 1750-1 Ikenobe, Miki-town, Kita-county, Kagawa, 761-0793, Japan
| | - Makiko Uemura
- Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Kagawa University, 1750-1 Ikenobe, Miki-town, Kita-county, Kagawa, 761-0793, Japan
| | - Haruyuki Fujita
- Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Kagawa University, 1750-1 Ikenobe, Miki-town, Kita-county, Kagawa, 761-0793, Japan
| | - Norimitsu Kadowaki
- Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Kagawa University, 1750-1 Ikenobe, Miki-town, Kita-county, Kagawa, 761-0793, Japan
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2
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Sustained spontaneous remission in KMT2A-MLLT3 mutated myeloid sarcoma. Ann Hematol 2023; 102:1271-1274. [PMID: 36930260 DOI: 10.1007/s00277-023-05173-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 03/09/2023] [Indexed: 03/18/2023]
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3
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Tutanov O, Tamkovich S. The Influence of Proteins on Fate and Biological Role of Circulating DNA. Int J Mol Sci 2022; 23:ijms23137224. [PMID: 35806228 PMCID: PMC9266439 DOI: 10.3390/ijms23137224] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 06/27/2022] [Accepted: 06/28/2022] [Indexed: 11/17/2022] Open
Abstract
Circulating DNA has already proven itself as a valuable tool in translational medicine. However, one of the overlooked areas of circulating DNA research is its association with different proteins, despite considerable evidence that this association might impact DNA’s fate in circulation and its biological role. In this review, we attempt to shed light on current ideas about circulating DNA origins and forms of circulation, known biological effects, and the clinical potential of circulating tumor deoxyribonucleoprotein complexes.
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4
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[A case of spontaneous remission of acute myeloid leukemia with MLL-AF9 rearrangement and abnormal liver function]. ZHONGHUA XUE YE XUE ZA ZHI = ZHONGHUA XUEYEXUE ZAZHI 2021; 42:851-857. [PMID: 34788926 PMCID: PMC8607016 DOI: 10.3760/cma.j.issn.0253-2727.2021.10.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Objective: To explore the clinical features and possible pathogenesis of spontaneous remission of acute myeloid leukemia (AML) . Methods: 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. Results: 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) . Conclusion: The spontaneous remission of leukemia is rare and may be related to immunosuppression and genes.
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5
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Patients with spontaneous remission of high-risk MDS and AML show persistent preleukemic clonal hematopoiesis. Blood Adv 2020; 3:2696-2699. [PMID: 31515231 DOI: 10.1182/bloodadvances.2019000265] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2019] [Accepted: 07/30/2019] [Indexed: 12/31/2022] Open
Abstract
Key Points
We report longitudinal mutational analyses of 2 patients with high-risk MDS and AML experiencing spontaneous disease remissions. Both patients had persistent clonal hematopoiesis during remission, harboring all but 1 of the mutations from the initial diagnostic sample.
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6
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Spontaneous Complete Remission in a Patient with Acute Myeloid Leukemia and Severe Sepsis. Case Rep Hematol 2017; 2017:9593750. [PMID: 28811942 PMCID: PMC5546120 DOI: 10.1155/2017/9593750] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2017] [Revised: 06/08/2017] [Accepted: 06/21/2017] [Indexed: 12/21/2022] Open
Abstract
Without treatment, acute myeloid leukemia (AML) is almost always fatal. Spontaneous remission of AML is a rare phenomenon and usually with a short duration. The exact mechanisms are unknown. However, its association with infection and blood transfusions has been described. We report a 53-year-old male who presented with severe sepsis and who was diagnosed with AML (M4). He has experienced complete spontaneous remission with relatively long duration. To the best of our knowledge, it is the first case of spontaneous remission described in Iran.
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7
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Alexeev I. Lorenz system in the thermodynamic modelling of leukaemia malignancy. Med Hypotheses 2017; 102:150-155. [PMID: 28478821 DOI: 10.1016/j.mehy.2017.03.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Revised: 03/19/2017] [Accepted: 03/25/2017] [Indexed: 11/24/2022]
Abstract
The core idea of the proposed thermodynamic modelling of malignancy in leukaemia is entropy arising within normal haematopoiesis. Mathematically its description is supposed to be similar to the Lorenz system of ordinary differential equations for simplified processes of heat flow in fluids. The hypothetical model provides a description of remission and relapse in leukaemia as two hierarchical and qualitatively different states of normal haematopoiesis with their own phase spaces. Phase space transition is possible through pitchfork bifurcation, which is considered the common symmetrical scenario for relapse, induced remission and the spontaneous remission of leukaemia. Cytopenia is regarded as an adaptive reaction of haematopoiesis to an increase in entropy caused by leukaemia clones. The following predictions are formulated: a) the percentage of leukaemia cells in marrow as a criterion of remission or relapse is not necessarily constant but is a variable value; b) the probability of remission depends upon normal haematopoiesis reaching bifurcation; c) the duration of remission depends upon the eradication of leukaemia cells through induction or consolidation therapies; d) excessively high doses of chemotherapy in consolidation may induce relapse.
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8
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Spontaneous Remission in an Older Patient with Relapsed FLT3 ITD Mutant AML. Case Rep Hematol 2016; 2016:1259759. [PMID: 28127477 PMCID: PMC5227128 DOI: 10.1155/2016/1259759] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Revised: 12/04/2016] [Accepted: 12/13/2016] [Indexed: 12/22/2022] Open
Abstract
Spontaneous remission (SR) of acute myeloid leukemia (AML) is a very rare phenomenon. AML characterized by FLT3 internal tandem duplication (FLT3 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 FLT3 ITD mutant AML in the literature. Our patient was an elderly woman with relapsed NPM1 and FLT3 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 FLT3 mutant AML.
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9
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Camus V, Etancelin P, Jardin F, Lenain P, Contentin N, Daliphard S, Buchonnet G, Lemasle E, Lanic H, Leprêtre S, Penther D, Dubois S, Tilly H, Bastard C, Stamatoullas A. Spontaneous remission in three cases of AML M5 with NPM1 mutation. Clin Case Rep 2015; 3:955-9. [PMID: 26576281 PMCID: PMC4641483 DOI: 10.1002/ccr3.408] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2015] [Revised: 08/20/2015] [Accepted: 09/10/2015] [Indexed: 12/22/2022] Open
Abstract
Patients with NPM1-mutated AML M5 who develop spontaneous remission (SR) after antibiotic therapy at diagnosis seem to form a favorable prognosis and chemo sensitive subtype. We report three cases of AML M5 patients with the same genotype that experienced transient SR and are now leukemia free after standard treatment.
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Affiliation(s)
- Vincent Camus
- Department of Haematology, Centre Henri Becquerel Rue d'Amiens, 76038, Rouen, France ; INSERM U918, Centre Henri Becquerel Rue d'Amiens, 76038, Rouen, France
| | - Pascaline Etancelin
- INSERM U918, Centre Henri Becquerel Rue d'Amiens, 76038, Rouen, France ; Department of Genetic Oncology, Centre Henri Becquerel Rue d'Amiens, 76038, Rouen, France
| | - Fabrice Jardin
- Department of Haematology, Centre Henri Becquerel Rue d'Amiens, 76038, Rouen, France ; INSERM U918, Centre Henri Becquerel Rue d'Amiens, 76038, Rouen, France
| | - Pascal Lenain
- Department of Haematology, Centre Henri Becquerel Rue d'Amiens, 76038, Rouen, France
| | - Nathalie Contentin
- Department of Haematology, Centre Henri Becquerel Rue d'Amiens, 76038, Rouen, France
| | - Sylvie Daliphard
- Department of Biological Haematology, Charles Nicolle University Hospital 76000, Rouen, France
| | - Gérard Buchonnet
- Department of Biological Haematology, Charles Nicolle University Hospital 76000, Rouen, France
| | - Emilie Lemasle
- Department of Haematology, Centre Henri Becquerel Rue d'Amiens, 76038, Rouen, France
| | - Hélène Lanic
- Department of Haematology, Centre Henri Becquerel Rue d'Amiens, 76038, Rouen, France
| | - Stéphane Leprêtre
- Department of Haematology, Centre Henri Becquerel Rue d'Amiens, 76038, Rouen, France ; INSERM U918, Centre Henri Becquerel Rue d'Amiens, 76038, Rouen, France
| | - Dominique Penther
- Department of Genetic Oncology, Centre Henri Becquerel Rue d'Amiens, 76038, Rouen, France
| | - Sydney Dubois
- Department of Haematology, Centre Henri Becquerel Rue d'Amiens, 76038, Rouen, France ; INSERM U918, Centre Henri Becquerel Rue d'Amiens, 76038, Rouen, France
| | - Hervé Tilly
- Department of Haematology, Centre Henri Becquerel Rue d'Amiens, 76038, Rouen, France ; INSERM U918, Centre Henri Becquerel Rue d'Amiens, 76038, Rouen, France
| | - Christian Bastard
- INSERM U918, Centre Henri Becquerel Rue d'Amiens, 76038, Rouen, France ; Department of Genetic Oncology, Centre Henri Becquerel Rue d'Amiens, 76038, Rouen, France
| | - Aspasia Stamatoullas
- Department of Haematology, Centre Henri Becquerel Rue d'Amiens, 76038, Rouen, France ; INSERM U918, Centre Henri Becquerel Rue d'Amiens, 76038, Rouen, France
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10
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Cardiopulmonary Failure Requiring ECMO Bypass Resulting from Leukemia Cell Lysis in a Patient with Childhood Acute Myelomonocytic Leukemia. Case Rep Hematol 2015; 2015:640528. [PMID: 26124967 PMCID: PMC4466370 DOI: 10.1155/2015/640528] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Accepted: 05/11/2015] [Indexed: 12/05/2022] Open
Abstract
Background. Childhood AML patients are at increased risk for early fatal pulmonary complications. Pulmonary leukostasis and systemic inflammatory response syndrome (SIRS) following leukemia cell lysis are the likely etiologies. Observation. Soon after initiation of AML chemotherapy, an 18-month-old female who met SIRS criteria sustained cardiopulmonary failure requiring ECMO support. Upon recovery, the patient went on to complete therapy and remains in remission without permanent neurologic or cardiac sequelae. Conclusion. Cytokine release syndrome from rapid cell lysis was the likely cause as infectious workup failed to reveal a definitive etiology and drug hypersensitivity testing to the chemotherapy agents was negative.
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11
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Myeloid leukemia of Down syndrome: relation to parvovirus B19 infection and wilms tumor gene (WT1) expression. J Pediatr Hematol Oncol 2015; 37:e67-8. [PMID: 24390447 DOI: 10.1097/mph.0000000000000093] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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12
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Purohit A, Aggarwal M, Kumar S, Seth T, Mishra P, Mahapatra M, Saxena R, Sharma R, Singh PK, Venkateshan S. Spontaneous remission of adult acute lymphoblastic leukemia: a very rare event. Indian J Hematol Blood Transfus 2014; 31:159-60. [PMID: 25548467 DOI: 10.1007/s12288-014-0351-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2013] [Accepted: 01/31/2014] [Indexed: 10/25/2022] Open
Abstract
A middle aged male presented to us with an unusual problem when his acute lymphoblastic leukemia (ALL) disappeared without any chemotherapy. We faced a dilemma whether to go ahead and treat his initial diagnosis or wait. Eventually he did relapse and was treated, albeit with a fatal outcome. Such spontaneous remission in acute leukemia are a very rare event, more common in acute myeloid leukemia and in children. Spontaneous remission in adult ALL is rarely described in literature.
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Affiliation(s)
- Abhishek Purohit
- Department of Hematology, All India Institute of Medical Sciences, New Delhi, India
| | - Mukul Aggarwal
- Department of Hematology, All India Institute of Medical Sciences, New Delhi, India
| | - Sudhir Kumar
- Department of Hematology, All India Institute of Medical Sciences, New Delhi, India
| | - Tulika Seth
- Department of Hematology, All India Institute of Medical Sciences, New Delhi, India
| | - Pravas Mishra
- Department of Hematology, All India Institute of Medical Sciences, New Delhi, India
| | - Manoranjan Mahapatra
- Department of Hematology, All India Institute of Medical Sciences, New Delhi, India
| | - Renu Saxena
- Department of Hematology, All India Institute of Medical Sciences, New Delhi, India
| | - Rahul Sharma
- Department of Hematology, All India Institute of Medical Sciences, New Delhi, India
| | - Pawan Kumar Singh
- Department of Hematology, All India Institute of Medical Sciences, New Delhi, India
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Abstract
Spontaneous remission (SR) of acute myeloid leukemia (AML) is rare. We collected all 46 reported cases of AML with SR. Fever occurred in 91.3% of cases before remission, which was largely due to pneumonia (54.5%) and bacteremia (24.2%). Pneumonia and bacteremia were significantly more common among those who achieved complete remission (CR) compared to those who achieved only a partial remission (p = 0.032). Although 88.6% of remissions were CR, the median duration of remission was only 5 months. Eight cases did not relapse during the follow-up period. The mechanism of SR in AML likely involves the stimulatory effect of systemic febrile infection on the immune system. Immediate treatment of infections and fever may contribute to the rarity of SR in AML. The results of this review improve our understanding of the important role of the immune system in countermanding AML and may provide new ideas for immunotherapy.
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Affiliation(s)
- Armin Rashidi
- Division of Oncology, Washington University School of Medicine , St. Louis, MO , USA
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14
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Spontaneous hematological remission of acute myeloid leukemia. Contemp Oncol (Pozn) 2014; 18:67-9. [PMID: 24876824 PMCID: PMC4037986 DOI: 10.5114/wo.2013.38915] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2013] [Revised: 10/18/2013] [Accepted: 11/08/2013] [Indexed: 12/04/2022] Open
Abstract
Spontaneous remission (SR) of acute myeloid leukemia (AML) in adults is observed very rarely. To date, about 100 cases have been presented in the literature. To our best knowledge, we describe the first adult Polish patient suffering from acute myelomonocytic leukemia (48, XY, +13, +21/46, XY), in whom after supportive therapy, including non-irradiated, non-leukocyte depleted red cell transfusions and low-dose corticosteroid, we observed resolution of the disease without cytogenetic remission. We suggest a potential transfusion-associated graft versus-host-diseases (TA-GVHD) and graft-versus leukemia (GVL) reaction which might lead to spontaneous hematological remission. However, we did not observe clinical symptoms of such reactions apart from a short episode of non-infectious diarrhea. Additionally, steroids were administered but their role in inducing SR, in our opinion, seems less probable. This 77-year-old man remained in SR for 7 months, when repeated analysis showed AML recurrence. He died due to septic shock 2.5 months later. Additionally, we present a review of the literature.
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15
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Zeng Q, Yuan Y, Li P, Chen T. Spontaneous remission in patients with acute myeloid leukemia with t(8;21) or cutaneous myeloid sarcoma: two case reports and a review of the literature. Intern Med 2013; 52:1227-33. [PMID: 23728561 DOI: 10.2169/internalmedicine.52.9505] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Spontaneous remission (SR) in patients with acute myeloid leukemia (AML) is rare. We herein present two such cases. The first case was of AML-M2 accompanied by a bone marrow cytogenetic analysis revealing 46, XY, t(8;21)(q22,q22). The second case was of isolated cutaneous myeloid sarcoma (MS) that progressed to AML within seven months. Both of the patients had symptoms of infection and anemia and were therefore treated with antibiotics and transfusions. The SR lasted for two months and one month, respectively. Currently, the mechanisms underlying SR remain ambiguous. Possible underlying mechanisms with a review of the related literature are discussed.
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MESH Headings
- Adult
- Chromosomes, Human, Pair 21/genetics
- Chromosomes, Human, Pair 8/genetics
- Female
- Humans
- Leukemia, Myeloid, Acute/diagnosis
- Leukemia, Myeloid, Acute/genetics
- Male
- Remission, Spontaneous
- Sarcoma, Myeloid/diagnosis
- Sarcoma, Myeloid/genetics
- Skin Neoplasms/diagnosis
- Skin Neoplasms/genetics
- Translocation, Genetic/genetics
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Affiliation(s)
- Qingchao Zeng
- Department of Hematology, Huashan Hospital, Fudan University, China
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16
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Abstract
Spontaneous remission in 2 children with myelofibrosis, one with megakaryocytic acute myeloblastic leukemia and t(1;22) (with recurrence later) and one with Down syndrome and GATA1 mutation (permanent), are described. One had sepsis and was treated with antibiotics and blood products, whereas the other received only blood products. Remission was spontaneous, without chemotherapy treatment. Possible explanations for these outcomes include immunologic response to sepsis by a leukemia-specific T-cell response or the release of various cytokines, such as tumor necrosis factor and interleukin-2, during infections. Natural killer and cytotoxic T cells transfused with blood products might have also triggered an immune response.
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17
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Cutaneous blastic plasmacytoid dendritic cell neoplasm occurring after spontaneous remission of acute myeloid leukemia: a case report and review of literature. Med Oncol 2012; 29:2417-22. [DOI: 10.1007/s12032-012-0215-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2012] [Accepted: 03/10/2012] [Indexed: 10/28/2022]
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18
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Müller-Schmah C, Solari L, Weis R, Pfeifer D, Scheibenbogen C, Trepel M, May AM, Engelhardt R, Lübbert M. Immune response as a possible mechanism of long-lasting disease control in spontaneous remission of MLL/AF9-positive acute myeloid leukemia. Ann Hematol 2011; 91:27-32. [DOI: 10.1007/s00277-011-1332-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2011] [Accepted: 08/30/2011] [Indexed: 12/26/2022]
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19
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Marisavljevic D, Markovic O, Zivkovic R. An unusual case of smoldering AML with prolonged indolent clinical course and spontaneous remission in the terminal phase. Med Oncol 2009; 26:476-9. [DOI: 10.1007/s12032-008-9153-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2008] [Accepted: 12/11/2008] [Indexed: 11/24/2022]
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20
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Transient spontaneous remission after tumor lysis syndrome triggered by a severe pulmonary infection in an adolescent boy with acute lymphoblastic leukemia. J Pediatr Hematol Oncol 2009; 31:76-9. [PMID: 19125097 DOI: 10.1097/mph.0b013e31818ab30c] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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21
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Jain N, Hubbard J, Vega F, Vidal G, Garcia-Manero G, Borthakur G. Spontaneous Remission of Acute Myeloid Leukemia: Report of Three Cases and Review of the Literature. ACTA ACUST UNITED AC 2008. [DOI: 10.3816/clk.2008.n.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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22
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Al-Tawfiq JA, Al-Khatti AA. Spontaneous remission of acute monocytic leukemia after infection with Clostridium septicum. Int J Lab Hematol 2007; 29:386-9. [PMID: 17824921 DOI: 10.1111/j.1365-2257.2006.00846.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Spontaneous remissions of acute myeloid leukemia (AML) have been reported in association with infection. Here, we report a case of spontaneous remission of AML in a 47-year-old Saudi Arabian male patient who presented with a few weeks history of recurrent abdominal pain, vomiting and fever. He was diagnosed with acute monocytic leukemia (AML, FAB M5b) and a perforated bowel. He also had Clostridium septicum bacteremia and thus chemotherapy was deferred. He received supportive therapy and intravenous antibiotics. Six weeks later, he achieved spontaneous and complete remission lasting for about 4 months. The remission and relapse were documented by bone marrow examination. Similarly, previous reports of spontaneous remission of AML were short lived and were followed by relapse and progression.
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Affiliation(s)
- J A Al-Tawfiq
- Internal Medicine Services Division, Dhahran Health Center, Saudi Aramco Medical Services Organization Saudi Aramco, Dhahran, Saudi Arabia.
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23
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Chan G, Pilichowska M. Complete remission in a patient with acute myelogenous leukemia treated with erlotinib for non–small-cell lung cancer. Blood 2007; 110:1079-80. [PMID: 17644748 DOI: 10.1182/blood-2007-01-069856] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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24
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Daccache A, Kizhakekuttu T, Siebert J, Veeder M. Hematologic and cytogenetic spontaneous remission in acute monocytic leukemia (FAB M5b) with trisomy 8. J Clin Oncol 2007; 25:344-6. [PMID: 17235053 DOI: 10.1200/jco.2006.08.8500] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Affiliation(s)
- Antoine Daccache
- Department of Internal Medicine, University of Illinois-Peoria, Peoria, IL, USA
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25
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Chen Z, Fadiel A, Naftolin F, Eichenbaum KD, Xia Y. Circulation DNA: biological implications for cancer metastasis and immunology. Med Hypotheses 2005; 65:956-61. [PMID: 16054303 DOI: 10.1016/j.mehy.2005.04.042] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2005] [Accepted: 04/28/2005] [Indexed: 11/18/2022]
Abstract
Circulation cell free DNA (cf-DNA) is of considerable interest to oncology researchers seeking to isolate specific cancer markers. Here, we focus on the origin and biological implications of cf-DNA, exploring its potential roles in cancer biology and medicine. We hypothesize that cf-DNA is primarily released by living cancer cells in addition to apoptotic or necrotic cancer cells for three reasons: (1) following radiotherapy, cf-DNA quantities are significantly reduced in a high percentage of patients although radiation-induced massive apoptosis is expected; (2) cancer cell DNA concentration in cultured supernatants increases with cell proliferation when few apoptotic or necrotic cells are present; and (3) DNA concentration increases in normal lymphocyte cultures following stimulation with phytohemagglutinin, lipopolysaccharide or antigen. Our hypotheses have major biological implications in cancer biology. First, cancer cf-DNA may transform normal cells and form adjacent or remote metastases or second primary cancer. In this context, we also have raised an alarming advice that the cancer may be potentially infectious. Secondly, if a normal cf-DNA contains cytokine sequence, it may behave like an intrinsic DNA vaccine, producing therapeutic cytokine. If normal cf-DNA contains a sequence of a non-mutated oncogene or tumor suppressor gene, homologous recombination with the cancer genome may occur leading to knock out mutated oncogene or tumor suppressor gene that could thus elicit a spontaneous remission of cancer.
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Affiliation(s)
- Z Chen
- Yale University School of Medicine, New Haven, CT 06520, USA
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Sonneck K, Mannhalter C, Krauth MT, Sperr WR, Schwarzinger I, Fonatsch C, Haas O, Geissler K, Valent P. An unusual case of myelodysplastic syndrome with prolonged clonal stability, indolent clinical course over a decade, and spontaneous regression of AML in the terminal phase. Eur J Haematol 2005; 75:73-7. [PMID: 15946315 DOI: 10.1111/j.1600-0609.2005.00423.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
An unusual case of secondary acute myeloid leukemia (AML) with indolent clinical course is described. The patient, a 67-yr-old female, had first been diagnosed to suffer from low-risk myelodysplastic syndrome, subtype refractory anemia with ringed sideroblasts, in 1992. In 2001, transformation to secondary AML with an increase in bone marrow blasts (>20%) and thrombocytopenia, was found. The patient did not require cytoreductive drugs. Rather, during the following months, spontaneous improvement of peripheral blood cells with normalization of platelets and decrease in the red cell transfusion frequency, were noted. In October 2002, she even became transfusion independent. However, the bone marrow still showed AML with >20% blasts. These blast cells exhibited a monoclonal pattern in the human androgen receptor (HUMARA) assay. However, no chromosomal defects occurred during a total observation period of 14 yr. We hypothesize that clonal stability may have contributed to the indolent course of the disease in this patient. The exact mechanisms underlying clinical and genetic stability remain unknown, however.
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Affiliation(s)
- Karoline Sonneck
- Division of Hematology and Hemostaseology, Department of Internal Medicine I, Medical University of Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria
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