Risk assessment in human immunodeficiency virus-associated acute myeloid leukemia

Michael W. Evans, Anthony D. Sung, Ivana Gojo, Michael Tidwell, Jacqueline Greer, Mark Levis, Judith Karp, Maria R. Baer

Research output: Contribution to journalReview article

Abstract

CD4 count ≤200×10 6 cells/L has been identified as a predictor of short survival in HIV-associated acute myeloid leukemia (HIV-AML), but karyotype, which is the best predictor of survival in AML, has not been evaluated in HIV-AML patients. A retrospective cohort of 31 patients was created from 9 local cases and 22 published cases. HIV-AML karyotypes were heterogeneous and were similar in distribution to those in HIV-negative AML. Among intensively treated patients, most achieved complete remission, but succumbed to infectious complications, mostly non-opportunistic, during consolidation therapy. Median survival for intensively-treated patients with CD4 counts ≤200×10 6 cells/L was 8.5 months, compared to 48 months for those with >200×10 6 CD4 cells/L (p=0.03). In contrast, AML karyotype did not predict survival (p=0.43), albeit with small numbers in each karyotype group. Thus, CD4 count is a strong predictor of short survival in HIV-AML patients regardless of karyotype. Studies evaluating innovative strategies for infection prophylaxis and for improving immune reconstitution are needed.

Original languageEnglish (US)
Pages (from-to)660-664
Number of pages5
JournalLeukemia and Lymphoma
Volume53
Issue number4
DOIs
StatePublished - Apr 1 2012

Keywords

  • Acquired immunodeficiency syndrome
  • Acute myeloid leukemia
  • Human immunodeficiency virus
  • Risk assessment

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

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