Acute promyelocytic leukemia after whole brain irradiation of primary brain lymphoma in an HIV-infected patient.
The occurrence of acute promyelocytic leukemia (APL) in HIV-infected patients has been reported in only five cases. Due to a very small number of reported HIV/APL patients who have been treated with different therapies with the variable outcome, the prognosis of APL in the setting of the HIV-infection is unclear. Here, we report a case of an HIV-patient who developed APL and upon treatment entered a complete remission. A 25-years old male patient was diagnosed with HIV-infection in 1996, but remained untreated. In 2004, the patient was diagnosed with primary central nervous system lymphoma. We treated the patient with antiretroviral therapy and whole-brain irradiation, resulting in complete remission of the lymphoma. In 2006, prompted by a sudden neutropenia, we carried out a set of diagnostic procedures, revealing APL. Induction therapy consisted of standard treatment with all-trans-retinoic-acid (ATRA) and idarubicin. Subsequent cytological and molecular ana?lysis of bone marrow demonstrated complete hematological and molecular remission. Due to the poor general condition, consolidation treatment with ATRA was given in March and April 2007. The last follow-up 14 months later, showed sustained molecular APL remission. In conclusion, we demonstrated that a complete molecular APL remission in an HIV-patient was achieved by using reduced-intensity treatment.
Boban
Ana
A
Division of Hematology, Department of Internal Medicine, Zagreb University School of Medicine and Clinical Hospital Center Zagreb, Kispaticeva 12, 10000 Zagreb, Croatia. ana.boban@zg.t-com.hr
Radman
I
I
Zadro
R
R
Dubravcic
K
K
Maretic
T
T
Civljak
R
R
Lisic
M
M
Begovac
J
J
D000328:Adult; D044966:Anti-Retroviral Agents / Q000627:therapeutic use; D000903:Antibiotics, Antineoplastic / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols; D023241:Antiretroviral Therapy, Highly Active / Q000379:methods; D001727:Bisexuality; D001921:Brain / Q000528:radiation effects*; D001932:Brain Neoplasms / Q000532:radiotherapy*; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D015255:Idarubicin / Q000627:therapeutic use; D015473:Leukemia, Promyelocytic, Acute / Q000209:etiology* / Q000473:pathology; D007953:Leukemia, Radiation-Induced / Q000209:etiology* / Q000473:pathology; D008223:Lymphoma / Q000532:radiotherapy*; D008297:Male; D012074:Remission Induction; D014212:Tretinoin
D044966:Anti-Retroviral Agents; D000903:Antibiotics, Antineoplastic; D014212:Tretinoin; D015255:Idarubicin