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Blood, 15 January 2002, Vol. 99, No. 2, pp. 698-701

BRIEF REPORT

Nonmyeloablative conditioning followed by transplantation of genetically modified HLA-matched peripheral blood progenitor cells for hematologic malignancies in patients with acquired immunodeficiency syndrome

Elizabeth M. Kang, Moniek de Witte, Harry Malech, Richard A. Morgan, Sheila Phang, Charles Carter, Susan F. Leitman, Richard Childs, A. John Barrett, Richard Little, and John F. Tisdale

From the Molecular and Clinical Hematology Branch, National Institute of Diabetes and Digestive and Kidney Diseases; National Institute of Allergy and Infectious Diseases; National Human Genome Research Institute; Department of Nursing and Department of Transfusion Medicine, Clinical Center; National Heart, Lung, and Blood Institute; and National Cancer Institute, National Institutes of Health, Bethesda, MD.

To assess the safety and efficacy of nonmyeloablative allogeneic transplantation in patients with HIV infection, a clinical protocol was initiated in patients with refractory hematologic malignancies and concomitant HIV infection. The results from the first 2 patients are reported. The indications for transplantation were treatment-related acute myelogenous leukemia and primary refractory Hodgkin disease in patients 1 and 2, respectively. Only patient 1 received genetically modified cells. Both patients tolerated the procedure well with minimal toxicity, and complete remissions were achieved in both patients, but patient 2 died of relapsed Hodgkin disease 12 months after transplantation. Patient 1 continues in complete remission with undetectable HIV levels and rising CD4 counts, and with both the therapeutic and control gene transfer vectors remaining detectable at low levels more than 2 years after transplantation. These results suggest that nonmyeloablative allogeneic transplantation in the context of highly active antiretroviral therapy is feasible in patients with treatment-sensitive HIV infection.

© 2002 by The American Society of Hematology.
 

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