Remission of acute myeloblastic leukemia after severe pneumonia treated with high-dose methylprednisolone

We report a case of acute myeloblastic leukemia (AML)-M2 (by French-America n-British classification) with t(8;21) (q22;q22) that was complicated with severe pneumonia. The patient tested positive by fluorescence in situ hybri dization (FISH) for AML1 splitting and positive by reverse transcriptase po lymerase chain reaction (RT PCR) for chimeric AML1/MTG8 messenger RNA (mRNA ), which indicated splitting of the MTG8 gene on chromosome 8 (q22) and the AML1 gene on chromosome 22 (q22). High-dose methylprednisolone was adminis tered, and the leukemic cells disappeared without chemotherapy, although dy splastic hematopoietic cells were observed transiently after the first ther apy. After the disappearance of leukemic cells, FISH for AML1 splitting was negative, and real-time PCR results for quantitative chimeric AML1/ MTG8 m RNA were less than the detectable level, however, RT PCR results for AML1/M TG8 mRNA remained positive. These findings suggest that the patient acquire d morphological, cytogenetic, and possibly molecular genetic remission by t he synergistic effects of severe infection and high-dose methylprednisolone . (C) 2001 The Japanese Society of Hematology.