Autologous Stem Cell Transplantation Of HIV-Positive Plasmablastic Lymphoma - Case Series

Area of Science:

• Hematology
• Oncology
• Infectious Diseases

Background:

• Plasmablastic lymphoma (PBL) is an aggressive non-Hodgkin lymphoma (NHL) often seen in immunocompromised individuals, particularly those with HIV.
• Historically, intensive therapies were contraindicated in HIV-positive patients due to infection risks.
• Advances in highly active antiretroviral therapy (HAART) have improved outcomes, enabling more aggressive treatment strategies.

Purpose of the Study:

• To evaluate the safety and efficacy of autologous stem cell transplantation (ASCT) as consolidation therapy for HIV-positive patients with PBL.
• To assess ASCT outcomes in patients achieving complete response (CR1) after first-line chemotherapy.

Main Methods:

• A case series of three HIV-positive PBL patients undergoing ASCT at first complete response (CR1) post-chemotherapy.
• Patients received dose-adjusted EPOCH chemotherapy and HAART, with temporary HAART cessation during conditioning.
• Data collected included clinical details, transplant specifics, and outcomes from a Bone Marrow Transplant (BMT) registry (January 2015 - December 2024).

Main Results:

• All three patients achieved complete metabolic response (CMR) prior to ASCT.
• The primary complications were manageable febrile neutropenia and mucositis; no opportunistic infections occurred.
• CD4 counts transiently decreased but stabilized post-transplant without significant long-term decline.

Conclusions:

• ASCT is a safe and effective consolidation option for HIV-positive PBL patients in CMR after induction chemotherapy.
• The procedure is well-tolerated with manageable complications and favorable outcomes.
• ASCT should be considered for eligible HIV-positive PBL patients to potentially improve disease-free survival.