INTRODUCTION
The current treatment regimens for acute lymphoblastic leukemia have
successfully attained cure rates of approximately 90-95%1,2. A remaining significant challenge, however, is to
improve the survival of patients with relapsed ALL. Patients with
relapsed ALL have a suboptimal prognosis 1,3. Down
syndrome patients with relapsed ALL have even worse outcomes. DS itself
was proved to be an independent prognostic factor of outcome after ALL
relapse.4 There are several case reports of patients
with leukemia who attained spontaneous remission after severe infection5-7. There are no reports of a patient with relapsed
leukemia with sustained remission following cessation of therapy
secondary to severe infections, except an older patient with relapsed
FLT3 internal tandem duplication mutant acute myeloid leukemia whose
disease underwent spontaneous remission for 35 days without
precipitating cause 8.
We describe a case of a 37 year-old man with Down syndrome and ALL who
had a late bone marrow relapse and sustained remission for 2 years after
only receiving three cycles of ALL R3 chemotherapy due to severe
systemic infections.