Autologous hematopoietic cell transplantation for HIV-related lymphoma: results of the BMT CTN 0803/AMC 071 trial

Abstract

Key Points Autologous hematopoietic cell transplantation is safe and effective in patients with HIV-related lymphoma who meet standard transplant criteria. Patients with HIV-related lymphomas should not be precluded from participating in AHCT clinical trials.

How I treat patients with HIV-related hematological malignancies using hematopoietic cell transplantation

“…There were no significant differences between these groups for OS, PFS, TRM, risk of lymphoma progression, or time to engraftment (Figure 1). 29 These data confirm findings from 2 prior case-control studies. 31,32 The effectiveness of hematopoietic progenitor cell (HPC) mobilization in HIV-infected patients also does not appear to differ from that of uninfected patients.…”

“…Immediately post-AHCT, he had a rise in his HIV viral load to 1024 copies per milliliter and a fall in his CD4 AHCT is the standard of care for patients with HRL with treatable HIV infections who otherwise meet standard transplant eligibility criteria. 29 This includes consideration of the underlying hematological malignancy and the prospects for cure using AHCT. Disease-based treatment considerations should reflect those used in the treatment of HIVuninfected patients.…”

“…29 This study evaluated 40 HIVinfected patients with chemotherapy-sensitive, relapsed, or persistent HRL (including 16 patients with HL). Beyond meeting standard organ function criteria used in prior BMT CTN trials, patients needed to have HIV infection that was treatable with cART and have no concurrent OIs.…”

Loss of immune homeostasis dictates SHIV rebound after stem-cell transplantation

“…Transplantation of HIV-protected cells in the autologous setting is safer than allogeneic transplantation and more readily available for patients (8)(9)(10). We have developed a model of cART-suppressed simian-human immunodeficiency viremia in the pigtail macaque (Macaca nemestrina).…”

A new standard for HIV-associated lymphoma

“…1 T he bone marrow (BM) preserves long-term repopulating hematopoietic stem cells (LT-HSCs) for life-long blood cell production and immunity. Hematopoietic stem cells (HSCs) reside predominantly in perivascular niches formed by sinusoidal endothelial and mesenchymal cells.…”