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Purpose: The study aims to observe the spontaneous remission of posterior vitreous detachment (PVD)-type vision degrading myodesopsia (VDM) during long-term follow-up. Methods: We retrospectively reviewed VDM patients with PVD type that refused any treatment. The ratio and time of significant spontaneous remission of floater symptoms occurring were described. The associated factors with significant remission of floater symptoms were analyzed in the univariate and multivariate logistic regression analyses. Results: In total, 179 patients with VDM were assessed. The mean age of all patients was 60.56 ± 0.47 years old, and the mean duration of follow-up was 23.89 ± 6.63 months. Of the patients, 40.78% have significant improvement in their floater symptoms after mean 16.55 ± 10.63-month follow-up. Myopia (OR = 0.280, 95% CI = 0.084–0.932, P = 0.038), the number of floaters > 3 (OR = 0.343, 95% CI = 0.172–0.683, P = 0.002), and floaters with string-like pattern (OR = 0.370, 95% CI = 0.166–0.824, P = 0.015) and blocky pattern (OR = 0.299, 95% CI = 0.090–0.993, P = 0.049) were negatively correlated with the significant spontaneous remission of VDM symptoms in the multiple binary logistic regression analysis. Conclusions: Approximately 40% of VDM patients with PVD may experience significant spontaneous remission during long-term follow-up. Patients that are non-myopic and with fewer floaters are more likely to feel relief from VDM symptoms. Floaters with string-like or blocky patterns are less likely to undergo spontaneous remission. [ABSTRACT FROM AUTHOR]

Epstein-Barr virus (EBV) -positive mucocutaneous ulcer (EBVMCU) was first described as a lymphoproliferative disorder in 2010. In recent years, EBVMCU has been reported in the field of oral surgery. On the other hand, medication-related osteonecrosis of the jaw (MRONJ) is an osteomyelitis that occurs in patients receiving antiresorptive agents including bisphosphonates (BP) and/or denosumab developing with bacterial infections such as dental diseases and mucositis. MRONJ caused by EBVMCU in the elderly has not been reported. Here, we report a rare case of MRONJ caused by EBVMCU in the elderly. The patient, an 82-year-old woman, had received BP for more than 2 years. An ulcerative lesion was found in the palatal mucosa; biopsy performed from the site confirmed the diagnosis of EBVMCU. At follow-up, the lesion disappeared spontaneously. At the 6-month follow-up, bone formation was observed at the site of the lesion, and the sequestrum was removed. At the 12-month follow-up healing of the EBVMCU region was seen indicating a good prognosis. [ABSTRACT FROM AUTHOR]

Purpose: Cerebral amyloid angiopathy-related inflammation (CAA-ri) is a rare potentially reversible encephalopathy associated with an autoimmune process against proteins deposited in the walls of cortical and leptomeningeal brain vessels. Definite diagnosis requires histopathological features of vascular inflammation and amyloid deposition from brain biopsy. Clinical-neuroradiological criteria have been recently introduced and validated to reduce the need for biopsy. The purpose of this paper is to report a historical retrospective review of clinical-neuroradiological follow-up of two patients with probable CAA-ri and five patients with a reasonably probable suspect of CAA-ri (4 females, 3 males, patient's age at admission: 66–79 years) seen at our institution between 2007 and 2021, focusing on clinical and neuroradiological awareness to this entity and variable response to immunotherapy. Materials and methods: Clinical features at presentation included subacute to acute confusion (6/7), seizures (4/7), cognitive impairment (5/7), and focal neurological signs (3/7). Neuroradiology included braincomputed tomography followed by magnetic resonance imaging. Infectious diseases and autoimmune workups were then performed. Results: CSF analysis was performed in two patients. Cerebral angiography was performed in two patients, to rule out vascular malformations. Hemorrhagic posterior reversible encephalopathy syndrome has been suspected in two patients. Four patients underwent immunotherapy with corticosteroids followed by reduction of brain dysfunctions. Three patients did not undergo immunotherapy but underwent clinical and/or neuroradiological remission. Conclusions: Patients with CAA-ri present a rare steroid-responsive acute to subacute brain dysfunction. Thus, it has to be known and recognized both clinically and neuroradiologically. Spontaneous clinical and/or neuroradiological improvement is possible in patients with mild symptoms. [ABSTRACT FROM AUTHOR]

Cancer is a leading causes of death. Despite significant success in the treatment of lymphatic system tumors, the problems of relapse, drug resistance and effectiveness of therapy remain relevant. Oncolytic viruses are able to replicate in tumor cells and destroy them without affecting normal, healthy tissues. By activating antitumor immunity, viruses are effective against malignant neoplasms of various nature. In lymphoproliferative diseases with a drug-resistant phenotype, many cases of remissions have been described after viral therapy. The current level of understanding of viral biology and the discovery of host cell interaction mechanisms made it possible to create unique strains with high oncoselectivity widely used in clinical practice in recent years. [ABSTRACT FROM AUTHOR]

Epileptic seizures might be provoked and/or exacerbated by fever or viral infection in children with epilepsy. However, this is not true for infantile spasms; in this study, we report three cases with infantile spasms became seizure free within 2–5 days following rotavirus gastroenteritis without an exchange or addition of antiepileptic drugs, and hypsarrhythmia evolved to diffuse slow waves or localized spikes on electroencephalography. We propose that the probability regarding the mechanism of spontaneous mitigation is the suppression of immunopathological processes caused by infection, while the possibility of ketogenic effects of diarrhea and intestinal flora recombination after rotavirus gastroenteritis is unlikely. Further study may provide important information concerning the mechanism of seizure control and the applicability to treatment for infantile spasms. [ABSTRACT FROM AUTHOR]

Diamond-Blackfan Anemia (DBA) is a congenital pure red cell aplasia caused by heterozygous variants in ribosomal protein genes. The hematological features associated with DBA are highly variable and non-hematological abnormalities are common. We report herein on an affected mother and her daughter presenting with transfusion-dependent anemia. The mother showed mild physical abnormalities and entered spontaneous remission at age 13 years. Her daughter was born with occipital meningocele. Exome sequencing of DNA from the mother revealed a heterozygous novel splice site variant (NM_001011.4:c.508-3T > G) in the Ribosomal Protein S7 gene (RPS7) inherited by the daughter. Functional analysis of the RPS7 variant expressed from a mini-gene construct revealed that the exon 7 acceptor splice site was replaced by a cryptic splice resulting in a transcript missing 64 bp of exon 7 (p.Val170Serfs*8). Our study confirms a pathogenic effect of a novel RPS7 variant in DBA associated with spontaneous remission in the mother and meningocele in her daughter, thus adding to the genotype–phenotype correlations in DBA. [ABSTRACT FROM AUTHOR]

Pregnancy-associated primary red cell aplasia (pPRCA) is a rare disorder that may occur at various time points during pregnancy. Unlike pregnancy-associated aplastic anemia, pPRCA is usually reversible, and no maternal deaths attributable to pPRCA have been reported. Herein, we report a woman diagnosed with pPRCA in two consecutive pregnancies. Corticosteroids were found to be ineffective, and she required a large number of red blood cell transfusions during both pregnancies. Despite severe anemia developing in both pregnancies, two healthy babies were vaginally born and spontaneous remission of pPRCA was seen after delivery. Interestingly, in both events of pPRCA described here, a transient rise of reticulocytes was observed precedent to the authentic recovery phase of reticulocytes and remission of pPRCA, which is a novel finding that has not been reported. The significance of this phenomenon has yet to be elucidated. Along with this case report, we review all 15 cases with 21 events of pPRCA in the literature, including the present case. [ABSTRACT FROM AUTHOR]

To review the literature about the use of Rabies Virus-Vaccine (RV-V) as an anticancer immunotherapeutic modality in the light of recent findings. The literature search in relevant databases with the following key words: Rabies virus, cancer, remission. Remissions occured following RV-V injections in patients with cervical cancer and melanoma. Pilot clinical studies showed that RV-V injections enhanced survival in glioblastoma patients, which is supported by findings in GL261 mouse glioma model. If public health studies demonstrate protective role of RV-V against certain types of cancers, it can be benefitted as a novel immune adjuvant in clinic. [ABSTRACT FROM AUTHOR]

Background: Neonatal leukemia is a rare disease with an estimated prevalence of about one to five in a million neonates. The majority being acute myeloid leukemia (AML), neonatal leukemia can present with a variety of symptoms including hyperleucocytosis, cytopenia, hepatosplenomegaly, and skin infiltrates. Chromosomal rearrangements including mixed lineage leukemia (MLL) translocations are common in neonatal AML. Case presentation: A female neonate born at 34 weeks gestation presented with cardiorespiratory failure, hepatosplenomegaly, pancytopenia, and coagulopathy. She required intensive care treatment including mechanical ventilation, high-dose catecholamine therapy, and multiple transfusions. Small intestinal biopsy obtained during laparotomy for meconium ileus revealed an infiltrate by an undifferentiated monoblastic, MLL-rearranged leukemia. No other manifestations of leukemia could be detected. After spontaneous clinical remission, lasting 5 months without any specific treatment, the patient presented with leukemia cutis and full-blown monoblastic leukemia. MLL-AF10-rearranged AML could be re-diagnosed and successfully treated with chemotherapy and hematopoietic stem cell transplantation. Conclusions: Our patient exhibited a unique manifestation of neonatal MLL-AF10 rearranged AML with cardiorespiratory failure and intestinal infiltration. It highlights the importance of leukemia in the differential diagnosis of neonatal distress, congenital hematological abnormalities, and skin lesions. [ABSTRACT FROM AUTHOR]

Severe childhood infections can occasionally be accompanied by bone marrow suppression. It is unusual for infection induced marrow aplasia to evolve into acute leukemia. We share our experience in managing four children with severe sepsis and pancytopenia which in due course evolved into acute leukemia. This report emphasizes that sepsis related pancytopenia can be a harbinger of evolving hematopoietic disorders. [ABSTRACT FROM AUTHOR]

Langerhans cell histiocytosis (LCH) is sometimes resistant to conventional chemotherapies, and treatment with 2-chlorodeoxyadenosine (2-CdA) is gaining importance as a salvage treatment for refractory or recurrent LCH. Secondary malignancies such as acute myelogenous leukemia and myelodysplastic syndrome (MDS) due to 2-CdA have recently been reported. However, there have been no reports to date of cases of 2-CdA-related secondary MDS in which spontaneous remission was achieved. Here, we report the case of a 1-year-old boy with an occipital tumor who was diagnosed with LCH by biopsy and underwent chemotherapy. However, the disease relapsed and became refractory to chemotherapy. He received 2-CdA treatment, which was effective. However 6 months after the start of treatment, he developed MDS with chromosomal abnormality of 7q−. After 1-year observation without any intervention, his hematological findings had returned to normal, and the chromosomal abnormality had also disappeared. To our knowledge, this is the first report of 2-CdA-related MDS with spontaneous hematological remission. [ABSTRACT FROM AUTHOR]

Spontaneous remission of acute myeloid leukemia (AML) is an extremely uncommon event. The etiology is associated with infection, blood transfusion or granulocyte colony-stimulating factor therapy, which trigger immune responses to exert an antileukemic effect. The remission is usually temporary and followed by rapid relapse. However, we present a case of a 42-year-old man with spontaneous remission of AML-M5a, who did not relapse but developed a rare and aggressive lymphoma, named cutaneous blastic plasmacytoid dendritic cell neoplasm (BPDCN). The neoplasm cells are positive for CD4, CD56, CD43, CD45, and CD123, but negative for other lineage-specific markers. To our knowledge, this is the first report of BPDCN occurring after spontaneous remission of AML, although it has been observed that some BPDCN could shift to myeloid leukemia. Occurrence of the two diseases is more than a coincidence. Discovery of such cases may shed further light on the inner connection between BPDCN and myeloid disorders. [ABSTRACT FROM AUTHOR]

Spontaneous complete remission (CR) is a rare, poorly understood phenomenon in acute myeloid leukemia (AML). We describe the 10-year follow-up of a patient with MLL-AF9-positive AML (Müller et al. Eur J Haematol 73:62-66, ), including ex vivo antileukemic immune responses which may contribute to the long-lasting spontaneous CR (tantamount to cure). We could demonstrate strong in vitro cytotoxic activity mediated by the patient's serum (cryopreserved at diagnosis 2001) against myeloid cell lines. We also addressed cellular cytotoxic activity against myeloid leukemia cells. When the patient's natural killer (NK) cells (obtained in 2007) were tested against the K562 cell line, upregulation of CD107 occurred, implying that long-term CR in this patient could be due to NK cell-mediated disease control. [ABSTRACT FROM AUTHOR]

Background: Relapse and spontaneous remission (SR) are characteristic features of autoimmune pancreatitis (AIP). Aim and methods: We conducted a study to determine if the predictive factors might be potentially related to the relapse in 70 consecutive AIP patients. Regarding SR, we studied the data of patients without corticosteroid treatment (CST). Results: CST was administered to 60% (42/70) of the patients; however, relapse was noted in 45.2% (19/42) of these patients. In 95% (18/19) of the AIP patients developing relapse, the relapse occurred within 3 years. The relapse rate was 80% (12/15) in the AIP patients administered CST for less than 12 months and 25.9% (7/27) in those administered CST for over 12 months ( p < 0.01). The results of univariate analysis revealed significant association of relapse with the presence of jaundice, IgG4 seropositivity, presence of diffuse pancreas swelling, duodenal papillitis (DP), history of initial CST, and history of supportive treatment ( p < 0.05), whereas multivariate analysis revealed that IgG4 seropositivity (OR 10.506, p = 0.0422) and the presence of jaundice (OR 6.945, p = 0.0174) are significant independent factors predictive of relapse in AIP patients. SR was recognized in 65.0% (13/20) of AIP patients without CST. The results of univariate analysis revealed that SR was associated with IgG4 seropositivity ( p < 0.05), and multivariate analysis identified IgG4 seropositivity (OR 0.032, p = 0.0092) as a significant independent factor predictive of SR in these cases. Conclusion: AIP patients with IgG4 seropositivity and jaundice are at a higher risk of relapse and they could therefore be candidates for over 3 years of maintenance CST. AIP patients with IgG4 seronegativity have a high likelihood of SR. [ABSTRACT FROM AUTHOR]

We describe here the spontaneous remission of a diffuse brainstem lesion found in an infant at the age of 7 weeks. Clinical and MRI characteristics strongly suggested a diffuse pontine glioma. Repeated MRI studies showed a continuous decrease in the size of the lesion, which was no longer visible by the age of 27 months. Spontaneous remission of diffuse pontine glioma is extremely rare; to our knowledge there are reports of only three similar cases. [ABSTRACT FROM AUTHOR]

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The clinical course and renal histological changes in two patients with congenital nephrotic syndrome are presented. Both patients developed edema and proteinuria at 2 days of age. Steroids and immunosuppressive drugs were not used in either patient. One patient showed gradual disappearance of nephrotic syndrome and proteinuria during the 16-month follow-up. In the other patient, the nephrotic state persisted and nephrotic complications necessitated bilateral nephrectomy when she was 12 months old. Renal biopsy showed minimal change lesions in one patient, while the nephrectomized kidneys showed mild mesangial proliferation and matrix increase in the glomeruli. No tubular dilatation or microcysts were observed in either patient. [ABSTRACT FROM AUTHOR]

Spontaneous remission of acute myeloid leukemia in the adult is a rare event. We report on a 31-year-old male patient suffering from acute myeloid leukemia (AML) M5a according to the French-American-British (FAB) classification with biphenotypic features in flow cytometric examination and severe bacterial infection with group G streptococci at the time of diagnosis. Because of sepsis and stable clinical conditions, chemotherapy was delayed and antibiotics were administered intravenously. Within 6 weeks a spontaneous remission of AML occurred. Remission lasted for about 2 months. At the time of relapse, a change in phenotype of the leukemic blasts with a loss of B-lymphoid markers could be demonstrated by flow cytometry. The patient was treated with an induction therapy according to the multicentric German AMLCG 2000 schedule. To our knowledge, this is the first report of a spontaneous remission in an AML FAB M5a associated with coexpression of myeloid- and lymphoid-associated antigens on the leukemic blasts. Possible mechanisms of this phenomenon are discussed with a review of the literature. [ABSTRACT FROM AUTHOR]

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Primary central nervous system lymphoma (PCNSL) is a relatively uncommon disease in which spontaneous remission is exceedingly rare. We are reporting three cases of primary CNS lymphoma with spontaneous regression in two to eight weeks, from the time of the initial diagnosis. The remission lasted for four years in the first case, two years in the second, and one year in the third case. Tissue diagnosis was made in the first two cases after relapse, and in the third case a biopsy was done at the initial presentation. The literature and the possible pathophysiological mechanisms of this interesting phenomenon are discussed. [ABSTRACT FROM AUTHOR]

Two cases with spontaneous regression of a histologically confirmed hepatocellular carcinoma (HCC) are presented. This rarely seen phenomenon of a spontaneous tumor involution is discussed and compared with the current literature. The clinical symptoms were very similar to that of a liver abscess. A 56-year-old male suffered from a multicentric, highly differentiated, trabecular HCC. First symptoms were epigastric pain, septic fever and arthritis. The tumor marker AFP was constantly normal and no hepatitis could be verified. A resection of the tumor was performed. In patient 2, a 74-year-old male, a multicentric, clear cell HCC was found. The patient had completely recovered from hepatitis type B and within the liver tissue no viruses could be identified. Clinical symptoms were mainly characterized by upper abdominal pain and septic fever. AFP was excessively elevated (3850 ng/ml) but returned to normal preoperatively. In both cases, the specimen showed a subtotal necrotic HCC with insignificant amounts of vital tumor cells. Neither patient had a liver cirrhosis macroscopically, however patient 2 had local periportal fibrosis histologically. After 24 and 41 months of follow-up, respectively, both patients are in good health and without evidence of tumor recurrence. Because of the common occurrence of vital tumor cells remaining within the necrosis as verified by histologic assessment of surgical specimens, we recommend surgical resection of HCC even when tumor regression is diagnosed. [ABSTRACT FROM AUTHOR]

Spontaneous remission without any anti-cancer therapy in a 57-year-old woman with adult T-cell leukemia (ATL) is reported. The patient was referred to our department because of persistent cough and appearance of abnormal lymphocytes in the peripheral blood, and she was diagnosed as having chronic ATL. Eight months later, she was re-admitted because of cystitis, watery diarrhea and worsening of respiratory symptoms with an increase of ATL cells (WBC 31 × 10/l with 56% ATL cells). Acute exacerbation of ATL was diagnosed. Interestingly, antibiotic therapy for the pulmonary and urinary tract infections brought about spontaneous reduction of the ATL cell count. Spontaneous remission of ATL continued for one year without chemotherapy. The role of infection as a trigger of acute exacerbation and spontaneous remission of ATL is discussed. [ABSTRACT FROM AUTHOR]

A patient with acute myelomonocytic leukemia who experienced a spontaneous remission, is reported. He had precedent and concurrent bacterial infections as most of these cases described. Low peripheral WBC and myeloblasts, Auer-rod positive blasts, bone marrow eosinophilia with atypical eosinophils, and a partial deletion of chromosome 16 were favorable prognostic parameters. A brief review of the literature and possible explanations for the regulation of granulopoiesis are presented. [ABSTRACT FROM AUTHOR]

On the basis of an assumption that leukemic progression is a process of adaptation of normal hemopoiesis to the effect of the leukemic clone, a theoretical model of leukemia development is built. General conclusions are as follows: the possibility of reaching remission depends upon suppression of normal hemopoiesis by cytostatics in a system of two cell populations: the duration of remission depends uponsuppression of the leukemic clone; the quantity of blast cells of marrow in remission can exceed 5 per cent. [ABSTRACT FROM AUTHOR]

Spontaneous remissions of acute myeloid leukemia (AML) have been documented in association with infection as well as blood transfusions. Activation of the immune system including an increased number of NK cells and cytokine release have been implicated in the mechanism of this phenomenon. We have observed spontaneous remissions in two patients with AML (one with a t(8;21)-positive M2, one with M5b), both occurring after infection and blood transfusions. The bone marrow showed a reduction of blast cells from 65% to 2% or 40% to 1%, respectively. Remission was accompanied by a marked polyclonal hypergammaglobulinemia in both cases (IgG values of 6420 and 2160 mg/dl, IgA of 802 and 811 mg/dl, respectively). A concomitant increase in bone marrow plasma cells was observed in both patients. Reduction of AML1/ETO PCR positivity from one-step to two-step PCR (approximately 100-fold) was documented in the patient with a t(8;21), while a regression of lymph node and skin leukemic infiltrations occurred in the patient with M5b. One patient relapsed after 4 months, at a time when his serum immunoglobulin levels had markedly decreased. The other patient is in continuous remission after 14 months. These cases suggest a potential role for a humoral immune response in the mechanism of spontaneous remission. [ABSTRACT FROM AUTHOR]

We present a 71-year-old patient with chronic lymphocytic leukemia diagnosed 27 years ago. Initially, the disease was staged as Rai II and the patient suffered from secondary immunoglobulin deficiency. Nevertheless, no treatment was necessary at that time. Because of disease progression a single course of chemotherapy was given in 1984. During the following year there was a constant decline of the WBC, accompanied by normalization of the immunoglobulins; both have remained stable ever since that time. However, there was still residual bone marrow infiltration, indicating persisting CLL. In 1993 cervical lymphadenopathy occurred with acute onset. A diagnostic lymphadenectomy revealed Hodgkin's disease of the nodular-sclerosing subtype. The patient was staged as II-III according to the Ann Arbor Classification and underwent radiation therapy. Cytogenetic examination of the bone marrow revealed a normal karyotype with an inversion of chromosome 9. This case demonstrates the rate coincidence of two lymphoproliferative disorders in the same patient. The clinical course and the immunologic findings of this patient are presented, together with a review of the literature. [ABSTRACT FROM AUTHOR]

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Spontaneous remission of adult acute myelogenous leukaemia (AML) represents a rare event. We report a 60-year-old female patient suffering from secondary AML M1 and severe invasive pulmonary hyalohyphomycosis highly suggestive of aspergillosis. Two months after the diagnosis of leukaemia, she achieved a spontaneous remission lasting 3 months, although neither cytostatic drugs nor corticoids were administered because of a septic condition. At the time of remission, a chronic hepatitis C virus infection and a polyclonal hypergammaglobulinaemia were present, and the patient received granulocyte colony-stimulating factor once. This report represents the first documentation of a spontaneous remission in AML following invasive pulmonary hyalohyphomycosis. Possible mechanisms of this phenomenon are discussed. [ABSTRACT FROM AUTHOR]

A middle aged male presented to us with an unusual problem when his acute lymphoblastic leukemia (ALL) disappeared without any chemotherapy. We faced a dilemma whether to go ahead and treat his initial diagnosis or wait. Eventually he did relapse and was treated, albeit with a fatal outcome. Such spontaneous remission in acute leukemia are a very rare event, more common in acute myeloid leukemia and in children. Spontaneous remission in adult ALL is rarely described in literature. [ABSTRACT FROM AUTHOR]

The author reflects on a clinical case which addresses the issue of spontaneous regression of colorectal cancer. He cites several uncertainties that confront the issue including the potential of incorrect diagnosis and the lack of clear data concerning the frequency of regression. He also mentions the implications of cytokine treatments on the occurrence spontaneous regression in cancer.

We describe a case of blood transfusion-dependent myelodysplastic syndrome (refractory anaemia), associated with macrocytosis and elevated percentage of hypochromic cells. Following an acute hospital admission with a respiratory tract infection, the patient entered a complete and sustained remission. [ABSTRACT FROM AUTHOR]

Die heute übliche Behandlungsweise eines Molluscum Contagiosums am kindlichen Augenlid besteht, wegen möglicher okulärer Komplikationen, in der frühzeitigen chirurgischen Entfernung. Allerdings nimmt man dabei die Risiken einer Vollnarkose in Kauf, ohne gesicherte epidemiologische Daten über einerseits die Häufigkeit okulärer Komplikationen und andererseits die Häufigkeit von Spontanremissionen. Dieser Fall zeigt die rasche und komplikationslose Remission eines Molluscum Contagiosum bei einem 5-jährigen Kind und befürwortet nach kritischem Studium der Literatur eine abwartende Haltung ohne chirurgische Intervention bei diesen jungen Patienten. Because of possible ocular complications, POMC on children’s eyelid, is usually treated with early surgical removal. General anaesthisia, which is need in the case of pediatric patients, is however associated with the well known risks of this procedure and furthermore there are no valid epidemiological data regarding the frequency of ocular complications and/or spontaneous remission. We report a spontaneous and rapid remission, without any ocular complications, of a POMC in a five year old child. This case and critical interpretation of the literature regarding this topic, support the observation of such patient without surgical intervention. [ABSTRACT FROM AUTHOR]

A 73-year-old man was admitted for investigation of pancytopenia. His physical examination was unremarkable and the bone marrow aspirate was compatible with myelodysplastic syndrome (RAEB). Cytogenetic analysis of the bone marrow revealed a trisomy 21. The patient received transfusions of packed red cells, and his condition remained stable for the next 7 months. He was then admitted with a chest infection and was treated with broad-spectrum antibiotics with satisfactory response. During his hospitalization there was a gradual increase in his complete blood count values, which persisted, resulting in a normal peripheral blood after 3 months. A bone marrow aspirate performed at that time revealed normal findings with no karyotypic abnormalities, indicating a spontaneous remission. The patient remained stable for the next 6 months; then he recurred with 20% blasts in his bone marrow and reappearance of trisomy 21 in 42% of the metaphases examined. Several hematologic malignancies with spontaneous remissions have been described to date, but they have generally been short and recurrence is the rule, as in the case described. The role of endogenous cytokines in triggering these spontaneous remissions is under question, as the exact mechanism is unknown. [ABSTRACT FROM AUTHOR]