Autologous peripheral blood stem cell transplantation for relapsed/refractory HIV-associated lymphoma: a phase II clinical study

Int J Hematol. 2020 Mar;111(3):434-439. doi: 10.1007/s12185-019-02791-y. Epub 2019 Dec 13.

Abstract

The outcome of relapsed/refractory HIV-associated lymphoma remains poor, even in the era of combined antiretroviral therapy. However, recent reports showed the efficacy of autologous stem cell transplantation (ASCT). We conducted a single-arm, multicenter phase II study in patients with relapsed/refractory HIV-associated lymphoma to assess the safety and efficacy of ASCT. The study included 14 patients with relapsed/refractory HIV-associated lymphoma. Five patients who achieved partial remission or better after the standard salvage regimen proceeded to ASCT. Conditioning treatment involved ranimustine (300 mg/m2) on day - 6, etoposide (200 mg/m2) on days - 5 to - 3, cytarabine (200 mg/m2) on days - 5 to - 3, and L-PAM (140 mg/m2) on day - 2. All patients achieved engraftment and were alive on day 100 of ASCT. One-year and 2-year overall survival rates were both 40% and 1-year and 2-year progression-free survival rates were both 40%. Grade 2 or 3 diarrhea and oral mucositis were observed in 43% of patients. Cytomegalovirus antigenemia, retinitis, and bacterial infections were noted in 43%, 29%, and 29% of patients, respectively. Therapy-related death was not observed. Although the number of enrolled patients was insufficient for statistical analysis. ASCT was feasible and safe for relapsed/refractory HIV-associated lymphoma.Registration: This study is registered in UMIN-CTR (UMIN000003159).

Keywords: Autologous stem cell transplantation; HIV; Lymphoma; Relapsed/refractory.

Publication types

  • Clinical Trial, Phase II
  • Multicenter Study

MeSH terms

  • Adult
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Cytarabine / administration & dosage
  • Etoposide / administration & dosage
  • Feasibility Studies
  • Humans
  • Lymphoma, AIDS-Related / mortality
  • Lymphoma, AIDS-Related / therapy*
  • Male
  • Melphalan / administration & dosage
  • Middle Aged
  • Neoplasm Recurrence, Local
  • Nitrosourea Compounds / administration & dosage
  • Peripheral Blood Stem Cell Transplantation*
  • Safety
  • Survival Rate
  • Transplantation, Autologous*

Substances

  • Nitrosourea Compounds
  • Cytarabine
  • Etoposide
  • Melphalan
  • ranimustine