title: Challenges to treatment of leukemia in HIV-positive children.
abstract: We describe the challenges to treatment of leukemia in three cases of human immunodeficiency virus (HIV)-infected children with multiple infections and complications. Two of the three patients had acute myeloid leukemia and the other one acute lymphoblastic leukemia. Two of the patients were known with HIV infection; the third was diagnosed on admission. All patients received antiretroviral therapy with standard doses of lamivudine, stavudine and efavirenz or lopinavir/retonavir. All three were diagnosed with Mycobacterium tuberculosis on one or more occasions: pulmonary or miliary involvement or tuberculous meningitis. One patient developed spinal paraplegia and needed an urgent laminectomy. Later he recovered almost completely. The interaction between antiretroviral and antituberculosis treatments combined with chemotherapy, antibiotics and supportive care is not known. Despite the severity and the complexity of several associated diseases, the outcome of the patients was rewarding and encouraging.
authors.forename: D Cristina
authors.initials: DC
authors.lastname: Stefan
authors.forename: Anel
authors.initials: A
authors.lastname: Dippenaar
authors.forename: Gerhard
authors.initials: G
authors.lastname: De Bruin
authors.forename: Ronelle
authors.initials: R
authors.lastname: Uys
authors.forename: Ronald
authors.initials: R
authors.lastname: van Toorn
mesh_terms: D019380:Anti-HIV Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D000995:Antitubercular Agents / Q000008:administration & dosage / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D007938:Leukemia / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification; D016896:Treatment Outcome; D014376:Tuberculosis / Q000175:diagnosis / Q000188:drug therapy; D019562:Viral Load / Q000187:drug effects
chemical_list: D019380:Anti-HIV Agents; D000970:Antineoplastic Agents; D000995:Antitubercular Agents