Spontaneous remission in adult patients with de novo myelodysplastic syndrome: a possible event

Background and Objectives. Spontaneous remission (SR) in de novo myelodyspl astic syndromes (MDS) is a rare event, which has been so far described only in children with monosomy 7. The phenomenon is extremely heterogeneous, pe rhaps depending on different pathogeneses of the disease. Design and Methods. We retrospectively evaluated the outcome of 564 consecu tive adult patents with primary MDS diagnosed at our Institution in a 12-ye ar period. SR was defined as an unexpected improvement lasting more than 1 year without concomitant treatments other than vitamins or low-dose steroid s (in patients with platelets < 50 x 10(9)/L). Results, Nine Gases of SR were observed in 3 males and 6 females (median ag e 38.7 years). At diagnosis, all patients had Hb levels < 10 g/dL and 8/9 r equired packed red cell transfusions, The median time from diagnosis to SR was 18 months (range 4-46) and all patients had normalization of peripheral blood parameters: in 2 out of 3 patients with karyotypic abnormalities at onset, a cytogenetic remission was documented. The median duration of SR wa s 56 months; 5 patients are still in SR and 4 patients have relapsed (1 as MDS and 3 as acute myeloid leukemia). Interpretation and Conclusions. SR is a rare (less than 2% in our experienc e) but possible event also in adult MDS patients. It should be kept in mind in the evaluation of experimental treatments for MDS in which very low rat es of complete responses are expected. (C) 2001, Ferrata Storti Foundation.