Restoration of effective hemopoiesis preceding suppression of leukemic clone in myeloblastic leukemia

A 63 year old Caucasian woman presented with myeloblastic leukemia and a hyperdiploid C group chromosome change in 10 per cent of marrow metaphases. Treatment with cytotoxic agents resulted in an increased percentage (52 per cent) of these hyperdiploid marrow cells. Furthermore, the marrow continued to show leukemic features morphologically and in culture. Despite the indications of persistence or progression of the hyperdiploid, putatively leukemic line at cessation of chemotherapy and for a period of time thereafter, remission was achieved and blood and marrow cell numbers one year after cessation of all treatment are normal. The hyperdiploid line is no longer detectable. This case raises questions concerning the mechanism whereby remission is attained in some cases of acute leukemia and is discussed in terms of the restoration of normal hemopoiesis eliminating the leukemic process.