Nonmyeloablative conditioning followed by transplantation of genetically modified HLA-matched peripheral blood progenitor cells for hematologic malignancies in patients with acquired immunodeficiency syndrome

Blood. 2002 Jan 15;99(2):698-701. doi: 10.1182/blood.v99.2.698.

Abstract

To assess the safety and efficacy of nonmyeloablative allogeneic transplantation in patients with HIV infection, a clinical protocol was initiated in patients with refractory hematologic malignancies and concomitant HIV infection. The results from the first 2 patients are reported. The indications for transplantation were treatment-related acute myelogenous leukemia and primary refractory Hodgkin disease in patients 1 and 2, respectively. Only patient 1 received genetically modified cells. Both patients tolerated the procedure well with minimal toxicity, and complete remissions were achieved in both patients, but patient 2 died of relapsed Hodgkin disease 12 months after transplantation. Patient 1 continues in complete remission with undetectable HIV levels and rising CD4 counts, and with both the therapeutic and control gene transfer vectors remaining detectable at low levels more than 2 years after transplantation. These results suggest that nonmyeloablative allogeneic transplantation in the context of highly active antiretroviral therapy is feasible in patients with treatment-sensitive HIV infection.

MeSH terms

  • Acquired Immunodeficiency Syndrome / complications
  • Acquired Immunodeficiency Syndrome / drug therapy
  • Acquired Immunodeficiency Syndrome / therapy*
  • Acute Disease
  • Adult
  • Anti-Bacterial Agents / therapeutic use
  • Antiretroviral Therapy, Highly Active
  • Cyclophosphamide / pharmacology
  • Cyclosporine / therapeutic use
  • Feasibility Studies
  • Ganciclovir / therapeutic use
  • Graft vs Host Disease / drug therapy
  • Graft vs Host Disease / etiology
  • Hematopoietic Stem Cell Transplantation*
  • Hodgkin Disease / complications
  • Hodgkin Disease / therapy*
  • Humans
  • Infection Control
  • Leukemia, Myeloid / complications
  • Leukemia, Myeloid / therapy*
  • Prednisone / therapeutic use
  • Premedication
  • Recurrence
  • Remission Induction
  • Transplantation Conditioning*
  • Treatment Outcome
  • Vidarabine / analogs & derivatives*
  • Vidarabine / pharmacology
  • Viral Load

Substances

  • Anti-Bacterial Agents
  • Cyclosporine
  • Cyclophosphamide
  • Vidarabine
  • fludarabine
  • Ganciclovir
  • Prednisone