Acute Lymphoblastic Leukemia Presenting With Pancytopenia Followed by a 14-Month-Long Period of Transient Remission Possibly Supporting the Adrenal Hypothesis of Leukemogenesis. Issue 8 (November 2016)

• Record Type: Journal Article
• Authors: Lynggaard, Line Stensig; Marquart, Hanne V.; Kjeldsen, Eigil; Madsen, Hans O.; Hasle, Henrik
• Is Part Of: Journal of pediatric hematology/oncology. Volume 38:Issue 8(2016)
• Page Start: e271
• Page End: e273
• Publication Date: 2016-11
• Subjects: acute lymphoblastic leukemia -- pancytopenia -- transient remission -- etiology -- pathogenesis; Pediatric hematology -- Periodicals; Tumors in children -- Periodicals; 618.9215
• DOI: 10.1097/MPH.0000000000000648
• Languages: English
• ISSNs: 1077-4114

Abstract

Abstract : A small group of children with acute lymphoblastic leukemia (ALL) have a preleukemic phase of pancytopenia followed by a period of spontaneous remission before the diagnosis (pre-ALL). A 6-year-old girl presented with pancytopenia, fever, and myelodysplasia. Following transient remission pre-B ALL was diagnosed 14 months later. Clonal B-lineage blasts at the period of pancytopenia were identified retrospectively. The interval between pre-ALL and ALL-diagnosis was longer than previously reported. The infection was clinically severe and might have induced a significant endogenous corticosteroids production resulting in the long-lasting remission. The case supports the adrenal and the Coley's toxin hypothesis in leukemogenesis.