Higher Risk Myelodysplastic Syndromes in Patients with Well-Controlled HIV Infection: Clinical Features, Treatment, and Outcome

Table 1

Clinical features, treatment, and outcome of 4 patients with higher IPSS risk MDS in the setting of well-controlled HIV infection.

Case

Age (years)

PMHx

ART

CD4 (cells/mL)

CD4%

HIV VL; (copies/mL)

FAB or WHO MDS diagnosis

Marrow blast count (%)

Cytogenetic analysis

IPSS score

MDS treatment

Follow-up (months)

Outcome

1^1

56

Hepatitis C

Abacavir; Efavirenz; Lamivudine

206

NR

Neg

RAEB^2

NR

Complex including del(5q) and -7

≥int2

NR

4

Progressed to AML

2^1

60

NHL

Abacavir; Lamivudine; Lopinavir

500

NR

NR

RAEB^2

NR

Complex including del(5q) and -7

≥int2

NR

6

Progressed to AML

3^3

63

None

Tenofovir; Efavirenz; Emtricitabine

296

<40

RAEB-2^4

12

Complex including; -5 and -7

High

None

3

Progressed to AML

4

56

None

Atazanavir; Emtricitabine; Tenofovir

1310

29

<40

RCMD^4

4

Complex including del(5q) and del(7q)

int2

AZA (2 cycles)

4

Septic death with possible AML progression

AML: acute myelogenous leukemia; ART: antiretroviral therapy; AZA: 5-azacitidine; del: deletion; FAB: French-American-British; HIV: human immunodeficiency virus; int: intermediate; IPSS: International Prognostic Scoring System; MDS: myelodysplastic syndrome; neg: negative; NHL: non-Hodgkin lymphoma; NR: not reported; PMHx: past medical history; WHO: World Health Organization; VL: viral load; ¹[30];  ²FAB; ³[32];  ⁴WHO.