Prolonged Remission in Acute Leukaemia

Abstract

This paper records two cases of unusually prolonged remission of acute leukaemia in children. The first patient, a 5-year-old girl, developed transient diabetes mellitus during her initial treatment with corticosteroids and has since been in complete remission for eight years. The second patient was a 9-year-old girl who developed toxic depression of the bone-marrow during treatment with mercaptopurine in a dosage of 150 mg./day (6.6 mg./kg./day). She has now been in complete remission for six and a half years. The possible role of the transient diabetic state in producing the prolonged remission in the first patient is discussed and reference is made to a short but inconclusive trial of glucagon in the treatment of acute leukaemia. In the second patient it is suggested that the toxic depression of the bone-marrow might have produced selective destruction of the original clone of leukaemic cells. Both children have been on continuous maintenance therapy with mercaptopurine, and this does not appear to have interfered with growth, secondary sexual development, and resistance to infection. © 1964, British Medical Journal Publishing Group. All rights reserved.