Co-occurrence of AIDS and acute promyelocytic leukemia: a case report and review of the literature

Acute promyelocytic leukemia (APL) is a rare and aggressive subtype of acute myelogenous leukemia (AML), characterized by the PML-RARA fusion gene. When APL presents concurrently with acquired immunodeficiency syndrome (AIDS), it creates unique challenges in diagnosis and treatment due to the immuno...

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Main Authors: Cheng Ai, Jianqiao Shentu, Hening Xu, Yongming Xia, Shiwei Duan
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-07-01
Series:Frontiers in Hematology
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Online Access:https://www.frontiersin.org/articles/10.3389/frhem.2025.1527938/full
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author Cheng Ai
Jianqiao Shentu
Hening Xu
Yongming Xia
Shiwei Duan
author_facet Cheng Ai
Jianqiao Shentu
Hening Xu
Yongming Xia
Shiwei Duan
author_sort Cheng Ai
collection DOAJ
description Acute promyelocytic leukemia (APL) is a rare and aggressive subtype of acute myelogenous leukemia (AML), characterized by the PML-RARA fusion gene. When APL presents concurrently with acquired immunodeficiency syndrome (AIDS), it creates unique challenges in diagnosis and treatment due to the immunocompromised state of the patient. This case report describes a 46-year-old male patient with long-standing AIDS who developed APL. Initial treatment involved all-trans retinoic acid (ATRA) monotherapy due to the patient’s severe lung infection and liver dysfunction, followed by the addition of arsenic trioxide (ATO) once infection and liver function improved. The patient achieved complete remission (CR) after combined ATRA and ATO therapy, with successful molecular remission of the PML-RARA fusion gene. We discuss the complexity of managing APL in the context of HIV infection, including the challenges posed by infections, liver dysfunction, and the impact of chemotherapy on antiretroviral therapy (ART). This case highlights the need for immediate initiation of ATRA in APL patients, even before genetic confirmation, and the potential therapeutic role of ATO in both leukemia treatment and HIV reservoir management. Further studies are needed to optimize treatment protocols for patients with concurrent AIDS and APL, focusing on personalized approaches to maximize efficacy while minimizing complications.
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spelling doaj-art-5bad81a4254b45cc9bb41493b6543b302025-08-20T03:27:25ZengFrontiers Media S.A.Frontiers in Hematology2813-39352025-07-01410.3389/frhem.2025.15279381527938Co-occurrence of AIDS and acute promyelocytic leukemia: a case report and review of the literatureCheng Ai0Jianqiao Shentu1Hening Xu2Yongming Xia3Shiwei Duan4Department of Hematology, Yuyao People’s Hospital of Zhejiang Province, The Affiliated Yangming Hospital of Ningbo University, Yuyao, Zhejiang, ChinaDepartment of Clinical Medicine, Hangzhou City University, Hangzhou, Zhejiang, ChinaDepartment of Clinical Medicine, Hangzhou City University, Hangzhou, Zhejiang, ChinaDepartment of Hematology, Yuyao People’s Hospital of Zhejiang Province, The Affiliated Yangming Hospital of Ningbo University, Yuyao, Zhejiang, ChinaDepartment of Clinical Medicine, Hangzhou City University, Hangzhou, Zhejiang, ChinaAcute promyelocytic leukemia (APL) is a rare and aggressive subtype of acute myelogenous leukemia (AML), characterized by the PML-RARA fusion gene. When APL presents concurrently with acquired immunodeficiency syndrome (AIDS), it creates unique challenges in diagnosis and treatment due to the immunocompromised state of the patient. This case report describes a 46-year-old male patient with long-standing AIDS who developed APL. Initial treatment involved all-trans retinoic acid (ATRA) monotherapy due to the patient’s severe lung infection and liver dysfunction, followed by the addition of arsenic trioxide (ATO) once infection and liver function improved. The patient achieved complete remission (CR) after combined ATRA and ATO therapy, with successful molecular remission of the PML-RARA fusion gene. We discuss the complexity of managing APL in the context of HIV infection, including the challenges posed by infections, liver dysfunction, and the impact of chemotherapy on antiretroviral therapy (ART). This case highlights the need for immediate initiation of ATRA in APL patients, even before genetic confirmation, and the potential therapeutic role of ATO in both leukemia treatment and HIV reservoir management. Further studies are needed to optimize treatment protocols for patients with concurrent AIDS and APL, focusing on personalized approaches to maximize efficacy while minimizing complications.https://www.frontiersin.org/articles/10.3389/frhem.2025.1527938/fullacute promyelocytic leukemia (APL)acquired immunodeficiency syndrome (AIDS)all-trans retinoic acid (ATRA)arsenic trioxide (ATO)PML-RARA fusion gene
spellingShingle Cheng Ai
Jianqiao Shentu
Hening Xu
Yongming Xia
Shiwei Duan
Co-occurrence of AIDS and acute promyelocytic leukemia: a case report and review of the literature
Frontiers in Hematology
acute promyelocytic leukemia (APL)
acquired immunodeficiency syndrome (AIDS)
all-trans retinoic acid (ATRA)
arsenic trioxide (ATO)
PML-RARA fusion gene
title Co-occurrence of AIDS and acute promyelocytic leukemia: a case report and review of the literature
title_full Co-occurrence of AIDS and acute promyelocytic leukemia: a case report and review of the literature
title_fullStr Co-occurrence of AIDS and acute promyelocytic leukemia: a case report and review of the literature
title_full_unstemmed Co-occurrence of AIDS and acute promyelocytic leukemia: a case report and review of the literature
title_short Co-occurrence of AIDS and acute promyelocytic leukemia: a case report and review of the literature
title_sort co occurrence of aids and acute promyelocytic leukemia a case report and review of the literature
topic acute promyelocytic leukemia (APL)
acquired immunodeficiency syndrome (AIDS)
all-trans retinoic acid (ATRA)
arsenic trioxide (ATO)
PML-RARA fusion gene
url https://www.frontiersin.org/articles/10.3389/frhem.2025.1527938/full
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