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Blood, 15 December 2001, Vol. 98, No. 13, pp. 3857-3859
BRIEF REPORT
Autologous stem cell transplantation for HIV-associated
lymphoma
Amrita Krishnan,
Arturo Molina,
John Zaia,
Auayporn Nademanee,
Neil Kogut,
Joseph Rosenthal,
Doni Woo, and
Stephen J. Forman
From the Division of Hematology and Bone Marrow
Transplantation, Division of Pediatrics (Virology and Infectious
Disease, Bone Marrow Transplantation); City of Hope Medical Center,
Duarte, California; The City of Hope-Southern California Kaiser
Permanente Bone Marrow Transplant Program.
Is peripheral stem cell mobilization followed by autologous stem
cell transplantation (ASCT) feasible in patients with human immunodeficiency virus (HIV)- associated lymphoma (HIV-L)?
Studies have demonstrated that, in the HIV- negative
(HIV ) setting, ASCT may improve lymphoma-free survival in
high-risk non-Hodgkin lymphoma (NHL) or relapsed Hodgkin
disease (HD) and NHL. Given the poor prognosis of HIV-L with
conventional chemotherapy, this dose-intensive approach was explored.
Nine patients with HIV-HD or NHL mobilized a median of
10.6 × 106 CD34+ cells/kg and engrafted
after ASCT. CD4 counts recovered to pretransplantation levels and HIV
viral loads were controlled in patients compliant with antiretroviral
therapy. Seven of 9 patients remain in remission from their lymphoma at
a median of 19 months after transplantation. Thus, patients with HIV-L
on antiretroviral therapy can engraft following ASCT. Prolonged
lymphoma remissions, without significant compromise of immune function,
can be seen, suggesting that ASCT can be used in selected patients with
HIV-L.
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