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Dr. Soad Al-Bahar, Consultant Haematologist, Kuwait Cancer Control Centre, PO 12391, Al-Shamiya 71654 (Kuwait) The association of acute myeloblastic leukemia (AML) and human immunodeficiency virus (HIV) infection is rare [1-4]. Previous reports have been from relatively high HIV prevalence areas. We report 2 cases of coexistent HIV infection and AML from a low HIV prevalence area. Casel An 18-year-old male presented in December 1991 with fever and fatigue. Physical examination showed mild cervical lymphadenopathy and hepatosplenomegaly. Laboratory investigations revealed hemoglobin (Hb) 9.9 g/dl, platelets 35 × 109/1, white blood cell count (WBC) 13.4 × 109/1, with 82% blasts in the peripheral blood smear. His bone marrow aspirate was markedly hypercellular with 80% blasts. On the basis of morphology and cytochemical reaction of the blasts, a diagnosis of acute myelomonocytic leukemia (FAB classification AML-M4) was made. Viral markers including enzyme-linked immunosorbent assay (Elisa) for HIV antibody were negative. He was treated with daunorubicin 45 mg/m2 on days 1, 3 and 5, cytosine arabinoside 100 mg/m2 and 6-thioguanine 100 mg/m2 on days 1-7. Remission induction therapy was complicated by fever and disseminated intravenous coagulopathy, treated with broad-spectrum antibiotics and blood component transfusions. He achieved complete remission and received two courses of consolidation chemotherapy. Both courses were complicated by myelosuppression and fever and required supportive care including blood component transfusions. In April 1992, he presented with generalized erythematous nodular cutaneous rash and marked cervical lymphadenopathy. Laboratory investigations showed normal hemogram, fine-needle aspiration cytology from the cervical lymph nodes showed many blasts and the bone marrow aspiration revealed 15% blasts. Histopathological examination of the cutaneous nodule revealed leukemic infiltrates. Elisa for HIV antibodies was positive, confirmed by Western blotting assay. He was treated in another hospital with combination chemotherapy and achieved complete remission. While in remission he developed a possible fungal pneumonia and intracerebral infection to which he succumbed. Case 2