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

Breccia, Massimo; Gentile, Giuseppe; Martino, Pietro; Petti, Maria Concetta; Russo, Eleonora; Mancini, Marco; Alimena, Giuliana

doi:10.1159/000076525

Cited by 7 publications

(2 citation statements)

References 11 publications

(18 reference statements)

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“…Finally, there are several reports of patients with MDS in HIV infection, including lower risk patients, who progressed rapidly (within 4–14 months) to AML following MDS diagnosis [ 30 , 70 , 71 ]. This suggests that the IPSS may, at least in some HIV-positive patients, underestimate the aggressiveness of the MDS and that these patients may be appropriate for vigilant monitoring and/or early intervention.…”

Section: Discussionmentioning

confidence: 99%

Higher Risk Myelodysplastic Syndromes in Patients with Well-Controlled HIV Infection: Clinical Features, Treatment, and Outcome

Williamson

Leitch

2016

Case Reports in Hematology

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Introduction. In advanced HIV prior to combination antiretroviral therapy (ART), dysplastic marrow changes occurred and resolved with ART. Few reports of myelodysplastic syndromes (MDS) in well-controlled HIV exist and management is undefined. Methods. Patients with well-controlled HIV and higher risk MDS were identified; characteristics, treatment, and outcomes were reviewed. Results. Of 292 MDS patients since 1996, 1 (0.3%) was HIV-positive. A 56-year-old woman presented with cytopenias. CD4 was 1310 cells/mL and HIV viral load <40 copies/mL. Bone marrow biopsy showed RCMD and karyotype included del(5q) and del(7q); IPSS was intermediate-2 risk. She received azacitidine at 75% dose. Cycle 2, at full dose, was complicated by marrow aplasia and possible AML; she elected palliation. Three additional HIV patients with higher risk MDS, aged 56–64, were identified from the literature. All had deletions involving chromosomes 5 and 7. MDS treatment of 2 was not reported and one received palliation; all died of AML. Conclusion. Four higher risk MDS in well-controlled HIV were below the median age of diagnosis for HIV-negative patients; all had adverse karyotype. This is the first report of an HIV patient receiving MDS treatment with azacitidine. Cytopenias were profound and dosing in HIV patients should be considered with caution.

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Section: Discussionmentioning

confidence: 99%

Higher Risk Myelodysplastic Syndromes in Patients with Well-Controlled HIV Infection: Clinical Features, Treatment, and Outcome

Williamson

Leitch

2016

Case Reports in Hematology

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“…casereportsandsmallseriesoccurredduringthepre-HAART period,indicatingapossibleroleforimmunodeficiencyinthe developmentofAML,withthemonocytotropismofHIVand chronic cytokine activation of monocytes and macrophages maybeexplainingthisassociation.Whilenon-Hodgkin'slymphoma occurs frequently in conjunction with AIDS illness, thepathogeneticlinksbetweenAMLandHIVhavenotyet been fully established [2,4,7,9,[11][12][13][14][15], and it is likely that therewereadditionalleukemogenicpathwaysinoperation [2]. The use of induction chemotherapy is a reasonable treatmentoptioninHIVpatientswithAML,andcompleteremission can be achieved.…”

Section: Case Reportmentioning

confidence: 99%

Alveolar Granulocytic Sarcoma of the Mandible in a Patient with HIV

Čolović¹,

Jurišić²,

Terzić³

et al. 2011

Oncol Res Treat

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Background: Granulocytic sarcoma (chloroma) occurs primarily in patients with acute myelogenous leukemia although it can also appear in connection with other myeloproliferative disorders. Case Report: We present the case of a 52-year-old human immunodeficiency virus (HIV)-positive female patient with a CD4+ count of 321 cells/ml, who developed an alveolar granulocytic sarcoma of the mandible. Pathological analysis of the tumor mass showed an infiltrate of immature cells which were positive for CD13, CD33, CD15, CD11b, and CD64, and negative for CD34, CD117, and HLA-DR. The patient achieved complete remission following a 1-week course of chemotherapy, however, 7 months later she developed a second granulocytic sarcoma in the left soleus muscle. The absolute CD4+ count had now reduced to 3 cells/ml with an inversion in the Th/Ts index (0.01), and she died of gram-negative sepsis 1 month later. Conclusions: Granulocytic sarcoma is extremely rare in patients with HIV. The case is discussed with reference to the literature.

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Pathology

Cesarman¹,

Chadburn²

2016

HIV-associated Hematological Malignancies

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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

Cited by 7 publications

References 11 publications

Higher Risk Myelodysplastic Syndromes in Patients with Well-Controlled HIV Infection: Clinical Features, Treatment, and Outcome

Higher Risk Myelodysplastic Syndromes in Patients with Well-Controlled HIV Infection: Clinical Features, Treatment, and Outcome

Alveolar Granulocytic Sarcoma of the Mandible in a Patient with HIV

Pathology

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