Abstract
The presence of substantial numbers of leukemic cells following completion of induction therapy for acute nonlymphocytic leukemia ordinarily indicates persistence of leukemia and is followed by complete relapse. We report 2 cases in which leukemic cells were present for 1-2 weeks after completion of induction therapy, yet complete remission was documented 7-12 days later without further induction treatment. They were treated with standard doses of Daunorubicin (Dnm) & Cytosine Arabinoside (Ara-C).
Several explanations are possible. The majority of leukemic cells may have been irreparably damaged by chemotherapy but were still able to go through several divisions, a type of bone marrow damage seen in experimental whole body irradiation. It is also possible that the therapy reduced the tumor load and the body managed to rid itself of a now manageable load of leukemic cells by some mechanism in response to the leukemia. The mode of action of this response could involve promotion of differentiation which has been shown both in established and fresh APL cell lines. We hope that investigations of cases such as ours can determine which of these mechanisms may pertain, since the implications for therapy would vary considerably.
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Feusner, J., Brecher, G. & Beach, B. PROLONGED PERSISTENCE OF LEUKEMIA CELLS AFTER INTENSIVE CHEMOTHERAPY FOLLOWED BY COMPLETE REMISSION WITHOUT FURTHER INTERVENTION. Pediatr Res 18 (Suppl 4), 239 (1984). https://doi.org/10.1203/00006450-198404001-00878
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DOI: https://doi.org/10.1203/00006450-198404001-00878