Proposed Immunology of the Spontaneous Remission of Acute Myleiod

Abstract

It is suggested that the spontaneous remission of acute myeloid leukemia, particularly hypoplastic acute myeloid leukemia seen after G-CSF treatment is possibly due to G-CSF augmenting an acute inflammatory response. This acute inflammatory response is one occurring during a low count of activated platelets and a low hemoglobulin. It appears that hypoplastic acute myeloid leukemia treated with G-CSF would be more likely to result in a remission if accompanied by an acute inflammatory response. The timing between subcutaneous G-CSF administration and an acute inflammatory response seems to be crucial to obtain an optimum acute inflammatory response and the optimum activation of innate immunity. Spontaneous remission of leukemia may be preceded with a low platelet count and anemia. A low count of activated platelets may diminish the immunosuppressive effects of activated platelets on innate and adoptive immunity. Anemia or low hemoglobulin may result in anerobic tissue respiration followed by lactic acidosis. Lactic acidosis in activating the enzyme lactate dehydrogenase and thereby dysfunctional cancer cells.