SPONTANEOUS REMISSION OF CHRONIC LYMPHOCYTIC-LEUKEMIA - A CASUISTIC CONTRIBUTION

Background: Spontaneous remission of malignant disease is very rare. In chronic lymphocytic leukemia (CLL) the frequency of spontaneous remission is reported as being 1%. Patient and Results: We report on a 50-year-old patient who was first admitted in 1984 for further evaluation of CLL. Initial findings were a lymphocytosis of 25,200/mul, lymphadenopathy, hepato- and splenomegaly and bone marrow infiltration with 60% mature lymphocytes. Neither anemia nor thrombocytopenia were noted. Immunoelectrophoresis revealed a polyclonal IgG and IgA activation while IgM was in the normal range. Within an 8-year follow-up a complete remission was observed. The benign clinical course in such cases poses the question of the differential diagnosis of chronic lymphoproliferative disease in adults. Polyclonal as well as monoclonal entities must be considered. Conclusions: Although in our case an immunophenotypic analysis was not initially performed in 1984, the clinical presentation as well as bone marrow examination and consideration of differential diagnosis leave no doubt in the diagnosis of spontaneous remission of CLL stage II.