Case Report
Spontaneous Remission in an Older Patient with Relapsed FLT3 ITD Mutant AML
Table 1
Laboratory and molecular results over the course of patient’s disease. AML: acute myeloid leukemia, AR: allelic ratio, BM: bone marrow, CR: complete remission, FLT3 ITD: FMS-like tyrosine kinase 3 internal tandem duplications, Hgb: hemoglobin, NPM1: nucleophosmin-1, PB: peripheral blood, SR: spontaneous remission, and WBC: white blood cell.
| | | Diagnosis
Day 1 | CR
Day 38 | Relapse
Day 270 (BM-1) | First SR
Day 277
(BM-2) | Second SR
Day 284
(BM-3) | Second relapse
Day 312 |
| | WBC (× 109/L) | 240 | 8.7 | 3.3 | 3.51 | 4.72 | 29.9 | | Hgb (g/dL) | 6.2 | 8.2 | 11.4 | 12.2 | 12.4 | 11.8 | | Platelets (× 109/L) | 119 | 483 | 115 | 150 | 171 | 63 | | PB blasts (%) | 74% | None | None | None | None | 16% | | BM blasts (%) | 73% | None | 64% | 3% | 2% | 84% | | Flow cytometry | Abnormal | No AML | Abnormal | No AML | No AML | Abnormal | BM
Cytogenetics | Normal | N.A. | del (15q) in 19/20 cells | del (15q)
in 1/20 cells | del (15q)
in 6/20 cells | del (15q) in 20/20 cells and del (16q) in 1/20 cells | | NPM1 mutation | + BM | + BM | + BM | + PB/+ BM | + BM | + BM | FLT3 ITD mutation
| + BM
(AR N.A.) | − BM | + BM
AR 0.36 | − BM/+ PB
AR 0.005 | + BM
AR 0.01 | +BM
AR 1.99 |
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