High-dose therapy and autologous peripheral-blood stem-cell transplantation as salvage treatment for HIV-associated lymphoma in patients receiving highly active antiretroviral therapy

Alessandro Re, Chiara Cattaneo, Mariagrazia Michieli, Salvatore Casari, Michele Spina, Maurizio Rupolo, Bernardino Allione, Annamaria Nosari, Clara Schiantarelli, Mariagrazia Viganò, Immacolata Izzi, Piero Ferremi, Arnalda Lanfranchi, Maurizio Mazzuccato, Gianpiero Carosi, Umberto Tirelli, Giuseppe Rossi

Research output: Contribution to journalArticle

104 Citations (Scopus)

Abstract

Purpose: High-dose therapy (HDT) and peripheral-blood stem-cell transplantation (PBSCT) in HIV-associated lymphoma (HIV-Ly) has been recently reported in selected patients. We describe the results of a multi-institutional program of HDT and PBSCT as salvage therapy in HIV-Ly responsive to highly active antiretroviral therapy (HAART) in unselected patients. Patients and Methods: Patients with resistant or relapsed HIV-Ly after first-line chemotherapy (CT) underwent PBSC collection after a course of second-line CT or cyclophosphamide and granulocyte colony-stimulating factor. Patients with chemotherapy-sensitive disease received carmustine, etoposide, cytarabine, and melphalan (BEAM regimen) and PBSC reinfusion. Effective HAART was maintained during the entire program. Results: Sixteen consecutive patients entered the program. Adequate collection of PBSC was obtained in 80% of patients (median CD34+ cells 6.8 × 106/kg). Three patients had early progression. Ten patients (62%) received PBSCT with prompt engraftment in all patients (neutrophils and platelet engraftment after a median of 10 days [range, 8 to 10 days] and 13 days [range, 8 to T 8 days], respectively). No patients died as a result of opportunistic or other infections or treatment-related complications. Eight of nine assessable patients achieved complete remission (one patient after radiotherapy for residual disease) and one patient achieved partial remission. Two patients experienced relapse and died at +10 and +14 months. Six patients are alive and disease free at a median of 8 months after transplantation. Conclusion: Our data confirm that HDT plus PBSCT is feasible and active as salvage therapy in HIV-Ly on a multi-institutional basis and in unselected HAART-responding patients. HIV infection should no longer preclude the opportunity of HDT in patients with lymphoma.

Original languageEnglish
Pages (from-to)4423-4427
Number of pages5
JournalJournal of Clinical Oncology
Volume21
Issue number23
DOIs
Publication statusPublished - Dec 1 2003

Fingerprint

Peripheral Blood Stem Cell Transplantation
Salvage Therapy
Highly Active Antiretroviral Therapy
Lymphoma
HIV
Therapeutics
Drug Therapy
Carmustine
Melphalan

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

High-dose therapy and autologous peripheral-blood stem-cell transplantation as salvage treatment for HIV-associated lymphoma in patients receiving highly active antiretroviral therapy. / Re, Alessandro; Cattaneo, Chiara; Michieli, Mariagrazia; Casari, Salvatore; Spina, Michele; Rupolo, Maurizio; Allione, Bernardino; Nosari, Annamaria; Schiantarelli, Clara; Viganò, Mariagrazia; Izzi, Immacolata; Ferremi, Piero; Lanfranchi, Arnalda; Mazzuccato, Maurizio; Carosi, Gianpiero; Tirelli, Umberto; Rossi, Giuseppe.

In: Journal of Clinical Oncology, Vol. 21, No. 23, 01.12.2003, p. 4423-4427.

Research output: Contribution to journalArticle

Re, A, Cattaneo, C, Michieli, M, Casari, S, Spina, M, Rupolo, M, Allione, B, Nosari, A, Schiantarelli, C, Viganò, M, Izzi, I, Ferremi, P, Lanfranchi, A, Mazzuccato, M, Carosi, G, Tirelli, U & Rossi, G 2003, 'High-dose therapy and autologous peripheral-blood stem-cell transplantation as salvage treatment for HIV-associated lymphoma in patients receiving highly active antiretroviral therapy', Journal of Clinical Oncology, vol. 21, no. 23, pp. 4423-4427. https://doi.org/10.1200/JCO.2003.06.039
Re, Alessandro ; Cattaneo, Chiara ; Michieli, Mariagrazia ; Casari, Salvatore ; Spina, Michele ; Rupolo, Maurizio ; Allione, Bernardino ; Nosari, Annamaria ; Schiantarelli, Clara ; Viganò, Mariagrazia ; Izzi, Immacolata ; Ferremi, Piero ; Lanfranchi, Arnalda ; Mazzuccato, Maurizio ; Carosi, Gianpiero ; Tirelli, Umberto ; Rossi, Giuseppe. / High-dose therapy and autologous peripheral-blood stem-cell transplantation as salvage treatment for HIV-associated lymphoma in patients receiving highly active antiretroviral therapy. In: Journal of Clinical Oncology. 2003 ; Vol. 21, No. 23. pp. 4423-4427.
@article{3d5049444dab4cb8ae1286aab1b8bf7f,
title = "High-dose therapy and autologous peripheral-blood stem-cell transplantation as salvage treatment for HIV-associated lymphoma in patients receiving highly active antiretroviral therapy",
abstract = "Purpose: High-dose therapy (HDT) and peripheral-blood stem-cell transplantation (PBSCT) in HIV-associated lymphoma (HIV-Ly) has been recently reported in selected patients. We describe the results of a multi-institutional program of HDT and PBSCT as salvage therapy in HIV-Ly responsive to highly active antiretroviral therapy (HAART) in unselected patients. Patients and Methods: Patients with resistant or relapsed HIV-Ly after first-line chemotherapy (CT) underwent PBSC collection after a course of second-line CT or cyclophosphamide and granulocyte colony-stimulating factor. Patients with chemotherapy-sensitive disease received carmustine, etoposide, cytarabine, and melphalan (BEAM regimen) and PBSC reinfusion. Effective HAART was maintained during the entire program. Results: Sixteen consecutive patients entered the program. Adequate collection of PBSC was obtained in 80{\%} of patients (median CD34+ cells 6.8 × 106/kg). Three patients had early progression. Ten patients (62{\%}) received PBSCT with prompt engraftment in all patients (neutrophils and platelet engraftment after a median of 10 days [range, 8 to 10 days] and 13 days [range, 8 to T 8 days], respectively). No patients died as a result of opportunistic or other infections or treatment-related complications. Eight of nine assessable patients achieved complete remission (one patient after radiotherapy for residual disease) and one patient achieved partial remission. Two patients experienced relapse and died at +10 and +14 months. Six patients are alive and disease free at a median of 8 months after transplantation. Conclusion: Our data confirm that HDT plus PBSCT is feasible and active as salvage therapy in HIV-Ly on a multi-institutional basis and in unselected HAART-responding patients. HIV infection should no longer preclude the opportunity of HDT in patients with lymphoma.",
author = "Alessandro Re and Chiara Cattaneo and Mariagrazia Michieli and Salvatore Casari and Michele Spina and Maurizio Rupolo and Bernardino Allione and Annamaria Nosari and Clara Schiantarelli and Mariagrazia Vigan{\`o} and Immacolata Izzi and Piero Ferremi and Arnalda Lanfranchi and Maurizio Mazzuccato and Gianpiero Carosi and Umberto Tirelli and Giuseppe Rossi",
year = "2003",
month = "12",
day = "1",
doi = "10.1200/JCO.2003.06.039",
language = "English",
volume = "21",
pages = "4423--4427",
journal = "Journal of Clinical Oncology",
issn = "0732-183X",
publisher = "American Society of Clinical Oncology",
number = "23",

}

TY - JOUR

T1 - High-dose therapy and autologous peripheral-blood stem-cell transplantation as salvage treatment for HIV-associated lymphoma in patients receiving highly active antiretroviral therapy

AU - Re, Alessandro

AU - Cattaneo, Chiara

AU - Michieli, Mariagrazia

AU - Casari, Salvatore

AU - Spina, Michele

AU - Rupolo, Maurizio

AU - Allione, Bernardino

AU - Nosari, Annamaria

AU - Schiantarelli, Clara

AU - Viganò, Mariagrazia

AU - Izzi, Immacolata

AU - Ferremi, Piero

AU - Lanfranchi, Arnalda

AU - Mazzuccato, Maurizio

AU - Carosi, Gianpiero

AU - Tirelli, Umberto

AU - Rossi, Giuseppe

PY - 2003/12/1

Y1 - 2003/12/1

N2 - Purpose: High-dose therapy (HDT) and peripheral-blood stem-cell transplantation (PBSCT) in HIV-associated lymphoma (HIV-Ly) has been recently reported in selected patients. We describe the results of a multi-institutional program of HDT and PBSCT as salvage therapy in HIV-Ly responsive to highly active antiretroviral therapy (HAART) in unselected patients. Patients and Methods: Patients with resistant or relapsed HIV-Ly after first-line chemotherapy (CT) underwent PBSC collection after a course of second-line CT or cyclophosphamide and granulocyte colony-stimulating factor. Patients with chemotherapy-sensitive disease received carmustine, etoposide, cytarabine, and melphalan (BEAM regimen) and PBSC reinfusion. Effective HAART was maintained during the entire program. Results: Sixteen consecutive patients entered the program. Adequate collection of PBSC was obtained in 80% of patients (median CD34+ cells 6.8 × 106/kg). Three patients had early progression. Ten patients (62%) received PBSCT with prompt engraftment in all patients (neutrophils and platelet engraftment after a median of 10 days [range, 8 to 10 days] and 13 days [range, 8 to T 8 days], respectively). No patients died as a result of opportunistic or other infections or treatment-related complications. Eight of nine assessable patients achieved complete remission (one patient after radiotherapy for residual disease) and one patient achieved partial remission. Two patients experienced relapse and died at +10 and +14 months. Six patients are alive and disease free at a median of 8 months after transplantation. Conclusion: Our data confirm that HDT plus PBSCT is feasible and active as salvage therapy in HIV-Ly on a multi-institutional basis and in unselected HAART-responding patients. HIV infection should no longer preclude the opportunity of HDT in patients with lymphoma.

AB - Purpose: High-dose therapy (HDT) and peripheral-blood stem-cell transplantation (PBSCT) in HIV-associated lymphoma (HIV-Ly) has been recently reported in selected patients. We describe the results of a multi-institutional program of HDT and PBSCT as salvage therapy in HIV-Ly responsive to highly active antiretroviral therapy (HAART) in unselected patients. Patients and Methods: Patients with resistant or relapsed HIV-Ly after first-line chemotherapy (CT) underwent PBSC collection after a course of second-line CT or cyclophosphamide and granulocyte colony-stimulating factor. Patients with chemotherapy-sensitive disease received carmustine, etoposide, cytarabine, and melphalan (BEAM regimen) and PBSC reinfusion. Effective HAART was maintained during the entire program. Results: Sixteen consecutive patients entered the program. Adequate collection of PBSC was obtained in 80% of patients (median CD34+ cells 6.8 × 106/kg). Three patients had early progression. Ten patients (62%) received PBSCT with prompt engraftment in all patients (neutrophils and platelet engraftment after a median of 10 days [range, 8 to 10 days] and 13 days [range, 8 to T 8 days], respectively). No patients died as a result of opportunistic or other infections or treatment-related complications. Eight of nine assessable patients achieved complete remission (one patient after radiotherapy for residual disease) and one patient achieved partial remission. Two patients experienced relapse and died at +10 and +14 months. Six patients are alive and disease free at a median of 8 months after transplantation. Conclusion: Our data confirm that HDT plus PBSCT is feasible and active as salvage therapy in HIV-Ly on a multi-institutional basis and in unselected HAART-responding patients. HIV infection should no longer preclude the opportunity of HDT in patients with lymphoma.

UR - http://www.scopus.com/inward/record.url?scp=0642276781&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0642276781&partnerID=8YFLogxK

U2 - 10.1200/JCO.2003.06.039

DO - 10.1200/JCO.2003.06.039

M3 - Article

VL - 21

SP - 4423

EP - 4427

JO - Journal of Clinical Oncology

JF - Journal of Clinical Oncology

SN - 0732-183X

IS - 23

ER -