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Autologous stem cell transplantation for HIV-associated lymphoma
1Division of Hematology and Bone Marrow Transplantation, City of Hope Medical Center, Duarte, California 91010, USA. akrishnan@coh.org
Blood
|December 12, 2001
Summary
Autologous stem cell transplantation (ASCT) is feasible for patients with human immunodeficiency virus (HIV)-associated lymphoma (HIV-L). This approach can lead to prolonged lymphoma remissions without compromising immune function in selected patients on antiretroviral therapy.
Area of Science:
- Hematology
- Oncology
- Infectious Diseases
Background:
- Autologous stem cell transplantation (ASCT) improves outcomes in HIV-negative patients with high-risk lymphoma.
- Conventional chemotherapy has a poor prognosis for HIV-associated lymphoma (HIV-L).
Purpose of the Study:
- To evaluate the feasibility and efficacy of ASCT in patients with HIV-associated lymphoma (HIV-L).
Main Methods:
- Nine patients with HIV-associated Hodgkin disease (HD) or non-Hodgkin lymphoma (NHL) underwent ASCT.
- Stem cell mobilization and engraftment were assessed.
- Immune function (CD4 counts) and HIV viral loads were monitored.
- Lymphoma remission status was tracked post-transplantation.
Main Results:
- All nine patients successfully mobilized stem cells and engrafted after ASCT.
- CD4 counts recovered to pre-transplantation levels, and HIV viral loads were controlled with antiretroviral therapy.
- Seven of nine patients achieved durable lymphoma remission at a median of 19 months post-transplantation.
Conclusions:
- ASCT is a feasible and potentially effective treatment for selected patients with HIV-L on antiretroviral therapy.
- This approach can achieve prolonged lymphoma remissions with manageable immune function.
- ASCT offers a promising dose-intensive option for HIV-L patients with poor prognoses.