Acute myeloid leukemia in patients infected with HIV-1.
| Autor: | Aboulafia DM; Division of Hematology/Oncology, Virginia Mason Medical Center, Seattle, Washington 98111, USA., Meneses M, Ginsberg S, Siegel MS, Howard WW, Dezube BJ |
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| Jazyk: | angličtina |
| Zdroj: | AIDS (London, England) [AIDS] 2002 Apr 12; Vol. 16 (6), pp. 865-76. |
| DOI: | 10.1097/00002030-200204120-00006 |
| Abstrakt: | Objectives: Myelodysplasia is a frequent consequence of HIV infection, but acute myeloid leukemia (AML) is rare. Clinical presentations and outcomes of patients with HIV and subsequent AML are reviewed. Methods: Five HIV-infected individuals who were subsequently diagnosed with AML were evaluated and treated. A further 42 cases of AML among patients with antecedent HIV infection were identified using MEDLINE, AIDSLINE, and CancerLit searches. Results: HIV infection was present for a median of 48 months (71-180) before AML was diagnosed and the median reported CD4 cell count was 210 x 106 cells/l. In five instances, a delay in diagnosis occurred when cytopenias were initially attributed to HIV or zidovudine-based therapy. In 45 patients, diagnosis was according to the French-American-British (FAB) leukemia classification schema and in two the FAB type was not specified. M2 (n = 15) and M4 (n = 14) subtypes represented 64% (29/45) of reported cases. Patients with a CD4 cell count < 200 x 106 cells/l (n = 11) had a median survival time of 7 weeks, while patients with a CD4 cell count >or= 200 x 106 cells/l (n = 7) had a median survival of 7 months (P = 0.005). Although long-lasting chemotherapy-induced responses were rare, the majority of treated patients did achieve complete hematologic remissions. Treatment-related morbidity did not appear to be excessive. Conclusion: In the absence of randomized and prospective clinical studies to guide decision making, this analysis indicates that induction chemotherapy may be a reasonable option for selected HIV-infected patients with AML and adequate immune function. |
| Databáze: | MEDLINE |
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