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Diagnostic dilemma for human immunodeficiency virus in a fatal case of acute myeloid leukemia.

Indian J Sex Transm Dis AIDS

December 2024

Department of Microbiology and Infectious Diseases, National HIV/AIDS Reference Laboratory, All India Institute of Medical Sciences, New Delhi, India.

National Human Immunodeficiency Virus (HIV) testing programs utilize antibody-based tests for confirming HIV diagnosis which has a diagnostic window period of 23-90 days. In Fiebig acute HIV Stage I-II, an individual has antibody-negative but RNA-positive test results. Here, we present a case of a 54-year-old complete remission acute myeloid leukemia patient, who was recently reported HIV negative by antibody-based tests used in National HIV testing programs.

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Objective: Acute myeloid leukaemia (AML) prognosis is enhanced with intensive remission induction chemotherapy (ICT) in eligible patients. However, ICT eligibility perceptions may differ among healthcare professionals. This nationwide, population-based study aimed to explore regional variation in ICT application and its relation with overall survival (OS).

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Introduction: Acute Myeloid Leukemia is a heterogeneous hematological malignancy characterized by the uncontrolled proliferation of abnormal myeloid cells. Besides several other genetic abnormalities developed in AML, FLT3 mutations are significant due to their worse prognostic impacts and therapeutic resistance. As a result, these mutations enable AML cells to develop mechanisms for evading immune surveillance.

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Acute myeloid leukemia (AML) is caused by altered maturation and differentiation of myeloid blasts, as well as transcriptional/epigenetic alterations, all leading to excessive proliferation of malignant blood cells in the bone marrow. Tumor heterogeneity due to the acquisition of new somatic alterations leads to a high rate of resistance to current therapies or reduces the efficacy of hematopoietic stem cell transplantation (HSCT), thus increasing the risk of relapse and mortality. Single-cell RNA sequencing (scRNA-seq) will enable the classification of AML and guide treatment approaches by profiling patients with different facets of the same disease, stratifying risk, and identifying new potential therapeutic targets at the time of diagnosis or after treatment.

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