Acute myeloid leukaemia in a patient with AIDS - case report

HIV-infected subjects are at increased risk of developing several cancers. Three of them - Kaposi's sarcoma, non-Hodgkin's lymphoma and invasive cervical cancer - are accepted as AIDS-defining malignancies. Acute myeloproliferative diseases are rare in HIV-infected individuals. HIV-seropositive patients with acute myeloid leukaemia (AML) are presented in the literature as isolated case reports. We describe a case of acute myeloid leukaemia (FAB-M5a) with Kaposi's sarcoma occurring in a HIV/EBV coinfected woman, sequentially treated with highly active antiretroviral therapy (ARV). She received treatment with a standard AML induction regimen consisting of infusion of cytarabine 200 mg/m(2) daily for 5 days, etoposide 100 mg daily for 5 days and idarubicin 10 mg/m(2) daily for 3 days, followed by double consolidation chemotherapy (I-cytarabine + mitoxantrone, II HD cytarabine). Complete remission (CR) lasting six months was achieved. HIV viral load increase was not observed. CD4+ cell count has remained above 200/mu l. ARV has resulted in a significant decline of mortality and opportunistic infections, improving overall survival among HIV-infected patients. Conventional chemotherapy regimens often followed by haematopoietic stem cell transplantation have become commonly used. As acute myeloid leukaemia is rare in HIV-infected individuals, recommendations on treatment have not been defined and each case is treated individually.