Blood, Vol. 95 No. 1 (January 1), 2000:
pp. 48-55
Changes in human immunodeficiency virus type 1 virus load
during mobilization and harvesting of hemopoietic progenitor cells
Thomas B. Campbell,
Anne Sevin,
Robert W. Coombs,
Gregory C. Peterson,
Mary Rosandich,
Daniel R. Kuritzkes,
Jeannette Mladenovic,
Alan Landay,
Roberta Wong,
Daniel Ambruso,
Steve Miles,
Roger J. Pomerantz,
Robert T. Schooley, and
the Adult AIDS Clinical Trials Group 285 Study Team
From the University of Colorado Health Sciences Center and Bonfils
Blood Center, Denver, CO; Harvard School of Public Health, Boston, MA;
University of Washington School of Medicine, Seattle, WA;
Rush-Presbyterian/St. Lukes Medical Center, Chicago, IL; Amgen, Inc.,
Thousand Oaks, CA; University of California Los Angeles School of
Medicine, Los Angeles, CA; and Center for Human Virology, Jefferson
Medical College of Thomas Jefferson University Hospital, Philadelphia,
PA.
Genetic modification of hemopoietic progenitor cells ex vivo,
followed by the infusion of the genetically modified cells into the
human immunodeficiency virus-1 (HIV-1) infected donor, has been
proposed as a treatment for HIV-1 infection. The current study was
undertaken to evaluate the effect of hemopoietic stem cell mobilization
and harvesting on HIV-1 replication in persons with HIV-1 infection.
Eighteen HIV-1-infected persons received recombinant granulocyte
colony-stimulating factor (G-CSF; Filgrastim) 10 µg/kg
per day, for 7 days. On days 4 and 5, peripheral blood mononuclear
cells were harvested by leukapheresis. The CD4+ lymphocyte count at
entry was >500/µL for 6 subjects, 200 to 500/µL for 6 subjects,
and <200/µL for 6 subjects. For 9 of 18 subjects, plasma HIV-1 RNA
levels increased 4- to 100-fold (>0.6 log10) above
baseline between days 4 and 7 and returned to baseline by day 27. Significant increases of plasma HIV-1 RNA levels occurred in 5 subjects
despite 3-drug antiretroviral therapy. Changes in CD4+ and CD34+
cells during mobilization and harvesting were similar in all subjects whether they had or did not have increased plasma HIV-1 RNA levels. Thus, mobilization and harvesting of bone marrow progenitor cells from persons infected with HIV-1 induced a transient increase in
viral replication in some patients but was not associated with adverse
effects. (Blood. 2000;95: 48-55)
