Pseudorelapse in acute myelomonocytic leukemia after high dose methylprednisolone.

High dose methylprednisolone (HDMP) has been used in induction treatment and in leukopenia of acute leukemia. We report the case of a 14-year-old girl with acute myelomonocytic leukemia (AMML) who developed a pseudorelapse after receiving an oral HDMP trial (30 mg/kg/day PO in the morning for 15 days) to overcome neutropenia. She presented with severe bone pain at the end of treatment. Bone marrow examination revealed 53% young promyelocytes (some with a large nucleolus), 2% myeloblast, 5% monocyte, and increased cellularity. Bone pain and promyelocytes regressed spontaneously while maintenance treatment continues. We advise that a pseudorelapse must be borne in mind after HDMP and probably GM-CSF treatments in acute leukaemias.