Acute myeloid leukemia secondary to a myelodysplastic syndrome with t(3;3) (q21;q26) in an HIV patient treated with chemotherapy and highly active antiretroviral therapy.
We describe the first case of secondary acute myeloid leukemia (AML) with t(3;3) (q21;q26) occurring in a human immunodeficiency virus (HIV)-infected patient sequentially treated with chemotherapy and highly active antiretroviral therapy (HAART). The t(3;3) is a nonrandom abnormality found in a small percentage of patients with myelodysplastic syndrome, secondary AML or chronic myeloid leukemia and is strongly associated with abnormal thrombopoiesis and a particularly poor prognosis. So far, it has never been observed in HIV-positive patients. Sporadic cases of AML have been reported in HIV patients and the feasibility of chemotherapy in association with HAART and disease outcome are still not clearly defined. Despite the poor response to chemotherapy in our case, which might also be related to the unfavorable karyotype, the secondary nature of the disease and the HIV positivity, the patient had a relatively long period of survival that could be due to the use of HAART. The association of chemotherapy with HAART appeared to be feasible and tolerable and could be suggested as a choice treatment in this peculiar subset of HIV/AML patients.
Breccia
Massimo
M
Department of Cellular Biotechnology and Hematology, University La Sapienza, Rome, Italy. breccia@bce.uniroma1.it
Gentile
Giuseppe
G
Martino
Pietro
P
Petti
Maria Concetta
MC
Russo
Eleonora
E
Mancini
Marco
M
Alimena
Giuliana
G
D044966:Anti-Retroviral Agents / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000627:therapeutic use; D002893:Chromosomes, Human, Pair 3; D004359:Drug Therapy, Combination; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy*; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy* / Q000209:etiology / Q000235:genetics; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000235:genetics; D016609:Neoplasms, Second Primary / Q000188:drug therapy / Q000209:etiology / Q000235:genetics; D014178:Translocation, Genetic; D016896:Treatment Outcome
D044966:Anti-Retroviral Agents; D000970:Antineoplastic Agents