Autologous stem cell transplantation for HIV-associated lymphoma

Blood. 2001 Dec 15;98(13):3857-9. doi: 10.1182/blood.v98.13.3857.

Abstract

Is peripheral stem cell mobilization followed by autologous stem cell transplantation (ASCT) feasible in patients with human immunodeficiency virus (HIV)- associated lymphoma (HIV-L)? Studies have demonstrated that, in the HIV- negative (HIV(-)) setting, ASCT may improve lymphoma-free survival in high-risk non-Hodgkin lymphoma (NHL) or relapsed Hodgkin disease (HD) and NHL. Given the poor prognosis of HIV-L with conventional chemotherapy, this dose-intensive approach was explored. Nine patients with HIV-HD or NHL mobilized a median of 10.6 x 10(6) CD34(+) cells/kg and engrafted after ASCT. CD4 counts recovered to pretransplantation levels and HIV viral loads were controlled in patients compliant with antiretroviral therapy. Seven of 9 patients remain in remission from their lymphoma at a median of 19 months after transplantation. Thus, patients with HIV-L on antiretroviral therapy can engraft following ASCT. Prolonged lymphoma remissions, without significant compromise of immune function, can be seen, suggesting that ASCT can be used in selected patients with HIV-L.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Antiretroviral Therapy, Highly Active
  • Bacterial Infections / complications
  • CD4 Lymphocyte Count
  • Child
  • Disease-Free Survival
  • Female
  • HIV Infections / drug therapy
  • HIV Infections / immunology
  • Hematopoietic Stem Cell Transplantation* / adverse effects
  • Humans
  • Lymphoma, AIDS-Related / immunology
  • Lymphoma, AIDS-Related / mortality
  • Lymphoma, AIDS-Related / therapy*
  • Male
  • Middle Aged
  • Neutropenia / complications
  • Opportunistic Infections / complications
  • Prognosis
  • Remission Induction
  • Transplantation Conditioning / adverse effects
  • Transplantation, Autologous