Boban Ana, Radman I, Zadro R, Dubravcic K, Maretic T, Civljak R, Lisic M, Begovac J
Division of Hematology, Department of Internal Medicine, Zagreb University School of Medicine and Clinical Hospital Center Zagreb, Kispaticeva 12, 10000 Zagreb, Croatia.
Eur J Med Res. 2009 Jan 28;14(1):42-3. doi: 10.1186/2047-783x-14-1-42.
The occurrence of acute promyelocytic leukemia (APL) in HIV-infected patients has been reported in only five cases. Due to a very small number of reported HIV/APL patients who have been treated with different therapies with the variable outcome, the prognosis of APL in the setting of the HIV-infection is unclear. Here, we report a case of an HIV-patient who developed APL and upon treatment entered a complete remission. A 25-years old male patient was diagnosed with HIV-infection in 1996, but remained untreated. In 2004, the patient was diagnosed with primary central nervous system lymphoma. We treated the patient with antiretroviral therapy and whole-brain irradiation, resulting in complete remission of the lymphoma. In 2006, prompted by a sudden neutropenia, we carried out a set of diagnostic procedures, revealing APL. Induction therapy consisted of standard treatment with all-trans-retinoic-acid (ATRA) and idarubicin. Subsequent cytological and molecular ana?lysis of bone marrow demonstrated complete hematological and molecular remission. Due to the poor general condition, consolidation treatment with ATRA was given in March and April 2007. The last follow-up 14 months later, showed sustained molecular APL remission. In conclusion, we demonstrated that a complete molecular APL remission in an HIV-patient was achieved by using reduced-intensity treatment.
据报道，HIV感染患者中仅出现过5例急性早幼粒细胞白血病（APL）。由于接受不同治疗且预后各异的HIV/APL患者报告数量极少，HIV感染情况下APL的预后尚不清楚。在此，我们报告一例HIV患者发生APL，经治疗后完全缓解。一名25岁男性患者于1996年被诊断为HIV感染，但未接受治疗。2004年，该患者被诊断为原发性中枢神经系统淋巴瘤。我们用抗逆转录病毒疗法和全脑照射对患者进行治疗，使淋巴瘤完全缓解。2006年，因突然出现中性粒细胞减少，我们进行了一系列诊断程序，发现为APL。诱导治疗包括使用全反式维甲酸（ATRA）和伊达比星的标准治疗。随后对骨髓进行的细胞学和分子分析显示完全血液学缓解和分子缓解。由于患者总体状况较差，于2007年3月和4月给予ATRA巩固治疗。14个月后的最后一次随访显示，APL分子持续缓解。总之，我们证明通过降低强度治疗可使HIV患者实现APL分子完全缓解。
