Advanced acute myelogenous leukaemia (AML) during HAART-treated HIV disease, manifesting initially as a thyroid mass

Abstract

A rare case report of acute myelogenous 46 XY, inv(16)(p13q22) leukaemia occurring in a patient with his HIV infection controlled by highly active antiretroviral therapy is reported, in the context of a review of the available literature evidences. The initial localization as an isolated thyroid mass has no clinical equivalents to date. Although at its initial presentation the haematological disease had a very advanced (M5) stage expressing a predominant monocytic phenotype, two 1-week cytotoxic chemotherapy cycles carried out with cytarabin-daunorubicin, achieved complete remission (as assessed by combined diagnostic imaging, and repeated bone marrow studies). At the present 11-month follow-up time, eventual bone marrow transplantation is under evaluation, since the chromosomal translocation was still present. A such favourable clinical response to acute, advanced myelogenous leukaemia with an insidious recognition is considered infrequent, especially in the setting of HIV disease.

Acute myelogenous leukemia in a child with HIV infection

“…A patient of advanced AML during highly active antiretroviral therapy (HAART)-treated HIV disease manifesting initially as a thyroid mass has been described with a favorable response to chemotherapy [8]. AML has also been reported in a patient with stage C3 AIDS who had been previously treated with granulocyte colony-stimulating factor; thus suggesting that activating the marrow elements to proliferate could spawn a mutational event that might lead to development of a malignant clone [3].…”

Alveolar Granulocytic Sarcoma of the Mandible in a Patient with HIV

“…HIV was probably a risk factor for the development of AMLinourpatient.Studiesofbonemarrowspecimenshave shownthatmyelodysplasiaisacommoncomplicationofHIV, andreportsofHIVpatientsdevelopingeachoftheFABclassification AML subtypes indicates that this association is probablynotcoincidental [4,6,[8][9][10].Themajorityofthese …”

“…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.…”