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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Frontiers Media S.A.
2025-07-01
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| 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. |
| format | Article |
| id | doaj-art-5bad81a4254b45cc9bb41493b6543b30 |
| institution | Kabale University |
| issn | 2813-3935 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Hematology |
| 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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