Spontaneous remission in 2 children with myelofibrosis, one with megakaryocytic acute myeloblastic leukemia and t(1;22) (with recurrence later) and one with Down syndrome and GATA1 mutation (permanent), are described. One had sepsis and was treated with antibiotics and blood products, whereas the other received only blood products. Remission was spontaneous, without chemotherapy treatment. Possible explanations for these outcomes include immunologic response to sepsis by a leukemia-specific T-cell response or the release of various cytokines, such as tumor necrosis factor and interleukin-2, during infections. Natural killer and cytotoxic T cells transfused with blood products might have also triggered an immune response.
*Department of Pediatric Hemato-Oncology
§Department of Pathology
¶Department of Pediatric Hemato-Oncology, Tel Aviv Medical Center, Tel Aviv University
†Hematology laboratory, Meir Medical Center, Kfar Saba
‡Institute of Human Genetics, Meyer Children's Hospital Rambam Health Care Campus
∥Functional Genomics and Childhood Leukemia Research, Sheba Medical Center Tel-Hashomer, Tel Aviv University, Israel
The authors declare no conflict of interest.
Reprints: Ronit Elhasid, MD, Pediatric Hemato-Oncology Unit, “Dana” Children’s Hospital, Tel Aviv Medical Center, 6 Weizman Street, Tel Aviv 64239, Israel (e-mail: firstname.lastname@example.org).
Received August 8, 2011
Accepted November 14, 2011