First and second complete remissions in a HIV positive patient following remission induction therapy for acute non‐lymphoblastic leukaemia

Abstract

A small number of patients positive for the human immunodeficiency virus (HIV) have been reported as developing acute non-Iymphoblastic leukaemia (ANLL) and none has achieved remission despite attempts at treatment.We report on a 34-year-old HIV positive heterosexual intravenous drug user who presented with ANLL (FAB classification M5, Monoblastic) and entered remission following one cycle of cytosine arabinoside and daunorubicin according to the 7-3 protocol of the Australian Leukaemia Study Group (ALSG). This was followed by consolidation of 5-2 as per ALSG and one cycle of maintenance with low dose cytosine arabinoside. Ten months after remission, he relapsed but achieved a second remission with the ALSG 7-3-7 protocol (7-3 plus etoposide) followed by consolidation with 5-2-5. He remained HIV positive b u t showed little progression towards the acquired immunodeficiency syndrome despite the intense immunosuppression. The duration of his second remission was five months. The patient died of septicaemia during the third attempt at remission induction 18 months after diagnosis.We conclude that HIV seropositivity is not an absolute contraindication to aggressive chemotherapy in those patients who develop ANLL. (Aust NZ J Med 1991; 21: 55-57.)

Acute myelogenous leukemia (FAB AML-M1) in the setting of HIV infection and G-CSF therapy: a case report and review of the literature

“…Monocytic cells often express the CD4 molecule, which serves as a receptor for HIV (gp 120) to enter and infect the cell. Severe leukopenia was present in cases 6 and 7 of those reported [7,13] and in the index case; however, WBC counts as high as 81.8! 10 3 /mm 3 have been reported as well (case 1) [10].…”

“…Despite this, patients with AIDS progressing to AML are rarely encountered [1][2][3][4][7][8][9][10][11][12][13][14]. With time, myelodysplasia may evolve into acute leukemia.…”

HIV/AIDS Case Histories: Acute Leukemia in an AIDS Patient

“…Numerous reports document successful remissions to both first and second line chemotherapy but, similar to the non-HIV-infected population, relapses are frequent. 6 Treatment with antiretroviral therapy alone does not appear to have any effect on the leukemia. Survival in chemotherapy-treated patients is approximately 10 months compared with less than 3 weeks in those who were not treated.…”

A 57‐year‐old HIV‐positive man with persistent fever, weight loss, and pancytopenia

“…In contrast acute myeloid leukemia in the setting of HIV infection is extremely rare, with publications on the topic limited to small series and case reports. Previously reported cases are of HIV-related AML have included FAB M0 [2], M1 [3,4], M2 [5][6][7][8], M3 [9,10], M4 [2,[10][11][12][13][14][15], and M5 [14][15][16][17], with M2 and M4 subtypes being the most frequently found subtypes. Of interest, myeloid sarcoma (granulocytic sarcoma or chloroma) has also been diagnosed in the context of HIV infection [18].…”