Immune Recovery after Autologous Stem Cell Transplantation Is Not Different for HIV‐Infected versus HIV‐Uninfected Patients with Relapsed or Refractory Lymphoma

Simonelli, Cecilia; Zanussi, Stefania; Pratesi, Chiara; Rupolo, Maurizio; Talamini, Renato; Caffau, C.; Bortolin, Monica; Tedeschi, Rosamaria; Basaglia, Giancarlo; Mazzucato, M.; Manuele, Rosa; Vaccher, Emanuela; Spina, Michele; Tirelli, Umberto; Michieli, Mariagrazia; Paoli, Paolo De

doi:10.1086/652866

Cited by 44 publications

(41 citation statements)

References 33 publications

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“…In almost all patients included in both analyses, cART was continued throughout the procedure, except for short interruptions. Furthermore, immune recovery after AHCT for HIV-related NHL is similar to that observed in HIV-negative patients [56,57].…”

Section: Ahct In Refractory or Relapsed Pbl Hiv-positive Patients Witsupporting

confidence: 65%

Hematopoietic Cell Transplantation for Plasmablastic Lymphoma: A Review

Malki

Castillo

Sloan

et al. 2014

Biology of Blood and Marrow Transplantation

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Plasmablastic lymphoma (PBL) is recognized by the World Health Organization as a very aggressive subtype of non-Hodgkin lymphoma. It was initially described in the setting of human immunodeficiency virus (HIV) infection, but it has since been identified in immunocompetent patients, as well. PBL is characterized by CD20 negativity and is associated with Epstein-Barr virus infection. The outcome with available therapy is poor, with median survival of less than 1 year. Multiple adverse prognostic factors have been identified, including HIV-negativity, MYC gene rearrangement, high-risk international prognostic index, and not achieving complete remission after induction therapy. The role of intensification of induction chemotherapy is controversial. Novel agents have shown some activity in relapsed setting and may have a role in upfront line of treatment. The outcome for relapsed PBL is dismal. Autologous hematopoietic cell transplantation (AHCT) appears to be feasible and may produce better results than chemotherapy, but definitive data are sparse. Chemosensitivity before transplantation might be required to benefit from such therapy. Some data suggest a better outcome of PBL if consolidation with AHCT is used in first-line setting, particularly for those with high-risk disease.

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Section: Ahct In Refractory or Relapsed Pbl Hiv-positive Patients Witsupporting

confidence: 65%

Hematopoietic Cell Transplantation for Plasmablastic Lymphoma: A Review

Malki

Castillo

Sloan

et al. 2014

Biology of Blood and Marrow Transplantation

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“…In HIVpositive patients, post-SCT lymphocyte subsets return to baseline at approximately 6 months. 8 In our patient we hypothesize that autoimmunity resolved following immune reconstitution.…”

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confidence: 61%

Persistent thrombocytopenia post auto-SCT for AML treated with romiplostim in a patient with HIV

Gangatharan

Cooney

2010

Bone Marrow Transplant

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“…Autologous stem cell transplantation (ASCT) by itself cannot significantly reduce the HIV-1 reservoir [13][14][15] ; in fact, infected lymphomonocytes are infused together with progenitor cells, hence, both the reservoir and the rest of the immune system are reconstituted. However, because it is a strengthened approach for AIDS-related lymphomas and more widely used than allogeneic transplantation, it offers a unique opportunity to evaluate strategies finalized to cure HIV-1 infection.…”

Section: Introductionmentioning

confidence: 99%

“…Herein, we retrospectively evaluated data on the HIV-1 reservoir from patients belonging to one of the largest and well-characterized monoinstitutional cohorts of cART-treated HIV-positive lymphoma patients who underwent ASCT. 14 …”

Section: Introductionmentioning

confidence: 99%

Autograft HIV-DNA Load Predicts HIV-1 Peripheral Reservoir After Stem Cell Transplantation for AIDS-Related Lymphoma Patients

Zanussi

Bortolin

Pratesi

et al. 2015

AIDS Research and Human Retroviruses

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Autologous stem cell transplantation (ASCT) is a widely used procedure for AIDS-related lymphomas, and it represents an opportunity to evaluate strategies curing HIV-1 infection. The association of autograft HIV-DNA load with peripheral blood HIV-1 reservoir before ASCT and its contribution in predicting HIV-1 reservoir size and stability during combination antiretroviral therapy (cART) after transplantation are unknown. Aiming to obtain information suggesting new functional cure strategies by ASCT, we retrospectively evaluated HIV-DNA load in autograft and in peripheral blood before and after transplantation in 13 cART-treated HIV-1 relapse/refractoring lymphoma patients. Among them seven discontinued cART after autograft infusion. HIV-DNA was evaluated by a sensitive quantitative real-time polymerase chain reaction (PCR). After debulking chemotherapy/mobilization, the autograft HIV-1 reservoir was higher than and not associated with the peripheral HIV-1 reservoir at baseline [median 215 HIV-DNA copies/10(6) autograft mononuclear cells, range 13-706 vs. 82 HIV-DNA copies/10(6) peripheral blood mononuclear cells (PBMCs), range 13-479, p = 0.03]. After high dose chemotherapy and autograft infusion, HIV-DNA levels reached a plateau between month 6 and 12 of follow-up. No association was found between peripheral HIV-DNA levels at baseline and after infusion in both cART interrupting and not interrupting patients. Only in the last subgroup, a stable significant linear association between autograft and peripheral blood HIV-1 reservoir emerged from month 1 (R(2) = 0.84, p = 0.01) to month 12 follow-up (R(2) = 0.99, p = 0.0005). In summary, autograft HIV-1 reservoir size could be influenced by the mobilization phase and predicts posttransplant peripheral HIV-1 reservoir size in patients on continuous cART. These findings could promote new research on strategies reducing the HIV-1 reservoir by using the ASCT procedure.

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Immune Recovery after Autologous Stem Cell Transplantation Is Not Different for HIV‐Infected versus HIV‐Uninfected Patients with Relapsed or Refractory Lymphoma

Abstract: Our study demonstrated that ASCT in HIV-infected persons with lymphoma does not worsen the initial immune impairment and does not enhance viral replication or the peripheral HIV reservoir in the long term.

Cited by 44 publications

References 33 publications

Hematopoietic Cell Transplantation for Plasmablastic Lymphoma: A Review

Hematopoietic Cell Transplantation for Plasmablastic Lymphoma: A Review

Persistent thrombocytopenia post auto-SCT for AML treated with romiplostim in a patient with HIV

Autograft HIV-DNA Load Predicts HIV-1 Peripheral Reservoir After Stem Cell Transplantation for AIDS-Related Lymphoma Patients

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