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Spontaneous Remission of Acute Myeloid Leukemia: A Case Report

2022; Multidisciplinary Digital Publishing Institute; Volume: 58; Issue: 7 Linguagem: Inglês

10.3390/medicina58070921

1648-9144

Yolanda Martínez-Díez, Aida Franganillo-Suárez, Rocío Salgado-Sánchez, Mireia Atance-Pasarisas, Carlos Blas, María José Cotti-Ferrari, Tamara Castaño-Bonilla, Daniel Láinez‐González, Socorro María Rodríguez‐Pinilla, Pilar Llamas, Juan Manuel Alonso‐Domínguez,

Chronic Myeloid Leukemia Treatments

Spontaneous remissions (SRs) in acute myeloid leukemia (AML) are infrequent, poorly documented and transient. Similarly, morphological and cytogenetic complete remissions (CR) under azacitidine treatment are scarce. We report a 71-year-old man with a secondary AML arising from essential thrombocythemia (ET), who developed an SR after discontinuation of azacitidine following a respiratory infection (four courses were administered). The distinctive feature of our case is the depth of the achieved CR, documented by next-generation sequencing (NGS) techniques. We also detected persistence of molecular lesions that might already have been present in the previous ET clone. Our patient relapsed 5 months after achieving CR. We conclude that our patient showed a spontaneous remission of his AML rather than an exquisite response to azacitidine. We hypothesize that the concurrent respiratory infection, or any other unknown trigger, might have activated his immune system forcing the leukemic stem cell to enter a quiescent state through a yet unexplained mechanism.