Autologous stem cell transplantation for HIV-associated lymphoma

A Krishnan, A Molina, J Zaia… - Blood, The Journal …, 2001 - ashpublications.org
A Krishnan, A Molina, J Zaia, A Nademanee, N Kogut, J Rosenthal, D Woo, SJ Forman
Blood, The Journal of the American Society of Hematology, 2001ashpublications.org
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 …
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 × 106 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.
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