Acute promyelocytic leukemia in HIV-infected adults: A case report and review of therapeutic considerations

Alexander Drilon, Eric Gamboa, Roodabeh Koolaee, Anupama Goel

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

Abstract

The incidence of acute promyelocytic leukemia (APL) in patients with HIV is exceedingly rare, making the establishment of therapeutic approaches challenging and often individualized. We report the case of a 43-year-old female who presented with fatigue and malaise, and was concurrently diagnosed with APL and HIV. Induction and consolidation with all-trans-retinoic acid (ATRA), idarubicin, and mitoxantrone were initiated in conjunction with highly active anti-retroviral therapy (HAART) consisting of tenofovir/emtricitabine, fosamprenavir, and raltegravir. A complete morphologic, cytogenetic, and molecular response was achieved post-induction. Therapeutic strategies should consider overlapping effects of current agents in targeting both pathologies. ATRA has been found to induce apoptosis in HIV-infected leukemic cells, and protease inhibitor therapy has furthermore been reported to be synergistic with ATRA in inducing differentiation of APL cell lines. Pending further investigation, regimens with protease inhibitor backbones may represent a viable first-line strategy for patients elected to receive HAART in addition to ATRA and standard chemotherapy.

Original languageEnglish
Pages (from-to)E47-E52
JournalClinical Lymphoma, Myeloma and Leukemia
Volume10
Issue number5
DOIs
StatePublished - Oct 2010
Externally publishedYes

Keywords

  • All-trans-retinoic acid
  • Arsenic trioxide
  • Highly active anti-retroviral therapy
  • Protease inhibitor therapy

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