Multiple Spontaneous Remissions in a Child with Acute Leukemia : The Occurrence of Agranulocytosis and Aplastic Anemia in Acute Leukemia and Their Relationship to Remissions

1. A case of acute leukemia with four observed spontaneous remissions is presented.

2. Spontaneous remissions in acute leukemia are infrequent and multiple remissions rare.

3. Spontaneous remissions in acute leukemia follow a pattern in that they occur after the development of a leukopenic agranulocytic phase and hypoplasia or aplasia of the marrow.

4. Remissions in acute leukemia when therapeutically induced probably follow a similar pattern.

5. The significance of agranulocytosis in acute leukemia has been discussed. When it occurs, before the diagnosis of leukemia is definitely made, and recovery ensues, one should be alerted for the possible later development of a characteristic picture of leukemia.

6. The possibility that idiopathic aplastic anemia is no more than a phase of acute leukemia has been discussed.