Antibiotic and glucocorticoid-induced recapitulated hematological remission in acute myeloid leukemia: A case report and review of literature

Figure 1 Morphological evaluation of the bone marrow and blood smears. A: A heavily hypercellular bone marrow with increased percentages of monoblasts (accounting for 44.5% of the total nucleated hematopoietic cells) and premonocytes (24.5%); B: Highly increased white blood cells with significantly increased percentages of premonocytes (accounting for 44% of the total nucleated cells) and monocytes (46%) in the blood smears.

Figure 2 Cytogenetic analysis for the bone marrow culture. Cytogenetic analysis by culture of the bone marrow sample reported a karyotype of 48,XY,t(8;21)(q22;q22),+13,+13[9]/49,idem, +mar[9]/49,idem,+8[2].

Figure 3 Sequential hematological changes following the antibiotic and dexamethasone treatments. Following the antibiotic and dexamethasone treatments, the white blood cells (× 10⁹/L) and the absolute monocytes counts (× 10⁹/L) gradually decreased, and the absolute neutrophil counts (× 10⁹/L), hemoglobin levels (× 10 g/L), platelets (10 × 10⁹/L) and the absolute reticulocytes counts (10 × 10⁹/L) gradually increased. The patient rapidly relapsed due to the discontinuation of the antibiotic and dexamethasone treatment. After relapse, repeating the same treatment resulted in the recapitulated hematological remission. WBC: White blood cell; ANC: Absolute neutrophil count; AMC: Absolute monocytes count; Hb: Hemoglobin; Plts: Platelets; Ret: Reticulocytes.