Persistent thrombocytopenia post auto-SCT for AML treated with romiplostim in a patient with HIV.

摘要

AML in the setting of HIV is rare. Delayed immune reconstitution remains a theoretical risk of treatment. We present a rare case in which auto-SCT was used for consolidation, complicated by autoimmune thrombocyto-penia managed by thrombopoietic growth factors.A 58-year-old man with HIV presented with pancyto-penia. BM biopsy confirmed AML with monoblastic morphology and trisomy 8 karyotype. Past history was significant for HIV diagnosed 10 years earlier, managed with antiretrovirals, etravirine 200 mg twice daily and the combination abacavir 300 mg/lamivudine 600 mg daily. At the time of AML diagnosis, HIV-1 RNA load was <40 copies/mL, with a CD4 count of 390 x 10~6/L and CD4/ CD8 ratio of 0.51. The patient also had a history of hepatitis C and had failed IFN and ribavirin treatment 5 years earlier, with a viral load of 1 x 10~7IU/mL at the time of AML diagnosis.