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Background <p>Acute myeloid leukemia is progressive and fatal if not treated with disease-directed therapy. There are reports of spontaneous remission in acute myeloid leukemia (AML) after preceding severe systemic infections and blood product transfusions.</p> Case presentation <p>A 27-year-old Ethiopian woman presented with the complaint of high grade fever, easy fatigability, abdominal pain, and occasional vomiting of 2 weeks duration. Physical examination revealed febrile to touch, tachycardia, conjunctival pallor, upper abdominal tenderness and tender hepatomegaly. Clinical evaluation, hematological workup and sonographic imaging settled diagnoses of AML and pyogenic liver abscess. She was treated with broad-spectrum antibiotics for 2 weeks during her stay in the hospital, and received multiple blood product transfusions. Then, she was referred to higher health institution for chemotherapy, where an additional diagnosis of invasive pulmonary aspergillosis was made based on microbiological workup and chest CT imaging, which prompted initiation of antifungal treatment. She was offered chemotherapy following completion of anti-fungal therapy. However, she traveled to abroad for better choices of therapy, where extensive investigations including bone marrow flow cytometry (minimal residua disease &lt; 0.01%) did not reveal any evidence of leukemia. Instead, multiple discrete cervical lymphadenopathies were noted and fine needle aspiration cytology suggested necrotizing granulomatous lymphadenitis, and then anti-tuberculosis drugs were initiated. On the fifth month of anti-tuberculosis treatment, she experienced high grade fever, headaches, neck stiffness and intermittent vomiting lasting for 2 weeks. Upon examination, she had positive meningeal irritation signs and left sided visual field defect and dilated and poorly reactive left pupil. On laboratory investigations, peripheral morphology, bone marrow aspirate and cerebrospinal fluid cytology revealed AML relapse. She died after 1 week of leukemia relapse despite antibiotics and blood component support.</p> Conclusion <p>Spontaneous remission in AML is transient and short-lived due to persisting residual leukemic clones. So then, periodic determination of hematological investigation during spontaneous remission is required for early detection of relapse.</p>

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Spontaneous remission of acute myeloid leukemia in Ethiopian woman: a case report

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年9月18日

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  • Muluken Abebe,
  • Abilo Tadesse,
  • Fikadu Alemiye,
  • Abera Gizaw,
  • Getaw Birhan,
  • Daniel Molla,
  • Segenet Bizuneh

摘要

Background

Acute myeloid leukemia is progressive and fatal if not treated with disease-directed therapy. There are reports of spontaneous remission in acute myeloid leukemia (AML) after preceding severe systemic infections and blood product transfusions.

Case presentation

A 27-year-old Ethiopian woman presented with the complaint of high grade fever, easy fatigability, abdominal pain, and occasional vomiting of 2 weeks duration. Physical examination revealed febrile to touch, tachycardia, conjunctival pallor, upper abdominal tenderness and tender hepatomegaly. Clinical evaluation, hematological workup and sonographic imaging settled diagnoses of AML and pyogenic liver abscess. She was treated with broad-spectrum antibiotics for 2 weeks during her stay in the hospital, and received multiple blood product transfusions. Then, she was referred to higher health institution for chemotherapy, where an additional diagnosis of invasive pulmonary aspergillosis was made based on microbiological workup and chest CT imaging, which prompted initiation of antifungal treatment. She was offered chemotherapy following completion of anti-fungal therapy. However, she traveled to abroad for better choices of therapy, where extensive investigations including bone marrow flow cytometry (minimal residua disease < 0.01%) did not reveal any evidence of leukemia. Instead, multiple discrete cervical lymphadenopathies were noted and fine needle aspiration cytology suggested necrotizing granulomatous lymphadenitis, and then anti-tuberculosis drugs were initiated. On the fifth month of anti-tuberculosis treatment, she experienced high grade fever, headaches, neck stiffness and intermittent vomiting lasting for 2 weeks. Upon examination, she had positive meningeal irritation signs and left sided visual field defect and dilated and poorly reactive left pupil. On laboratory investigations, peripheral morphology, bone marrow aspirate and cerebrospinal fluid cytology revealed AML relapse. She died after 1 week of leukemia relapse despite antibiotics and blood component support.

Conclusion

Spontaneous remission in AML is transient and short-lived due to persisting residual leukemic clones. So then, periodic determination of hematological investigation during spontaneous remission is required for early detection of relapse.