High-dose therapy and autologous peripheral blood stem cell transplantation as salvage treatment for AIDS-related lymphoma: Long-term results of the Italian Cooperative Group on AIDS and Tumors (GICAT) study with analysis of prognostic factors

Alessandro Re, Mariagrazia Michieli, Salvatore Casari, Bernardino Allione, Chiara Cattaneo, Maurizio Rupolo, Michele Spina, Rosa Manuele, Emanuela Vaccher, Mario Mazzucato, Luciano Abbruzzese, Pierino Ferremi, Giampiero Carosi, Umberto Tirelli, Giuseppe Rossi

Research output: Contribution to journalArticle

88 Citations (Scopus)

Abstract

After the introduction of highly active antiretroviral therapy (HAART), intensive treatment, including high-dose therapy (HDT) and peripheral blood stem cell transplantation (PBSCT), has become feasible in HIV-positive patients with Hodgkin (HL) and non-Hodgkin (NHL) lymphoma. Herein, we report the long-term results, on an intention-to-treat basis, of a prospective study on HDT and PBSCT in 50 HIV-positive HAART-responding patients with refractory/relapsed lymphoma. After debulking therapy, 2 patients had early toxic deaths, 10 had chemoresistant disease, 6 failed stem cell mobilization, 1 refused collection, and 4 progressed soon after PBSC harvest. Twenty-seven actually received transplant. Twenty-one patients are alive and disease-free after a median follow-up of 44 months (OS, 74.6%; PFS, 75.9%). Only lymphoma response significantly affected OS after transplantation. In multivariate analyses both lymphoma stage and low CD4 count negatively influenced the possibility to receive transplant. Median OS of all 50 eligible patients was 33 months (OS, 49.8%; PFS, 48.9%). Low CD4 count, marrow involvement, and poor performance status independently affected survival. PBSCT is a highly effective salvage treatment for chemosensitive AIDS-related lymphoma. It seems rational to explore its use earlier during the course of lymphoma to increase the proportion of patients who can actually receive transplant.

Original languageEnglish
Pages (from-to)1306-1313
Number of pages8
JournalBlood
Volume114
Issue number7
DOIs
Publication statusPublished - 2009

Fingerprint

AIDS-Related Lymphoma
Peripheral Blood Stem Cell Transplantation
Salvaging
Salvage Therapy
Stem cells
Transplants
Tumors
Acquired Immunodeficiency Syndrome
Blood
Lymphoma
Neoplasms
Highly Active Antiretroviral Therapy
CD4 Lymphocyte Count
Poisons
Therapeutics
HIV
Refractory materials
Hematopoietic Stem Cell Mobilization
Hodgkin Disease
Non-Hodgkin's Lymphoma

ASJC Scopus subject areas

  • Hematology
  • Biochemistry
  • Cell Biology
  • Immunology

Cite this

High-dose therapy and autologous peripheral blood stem cell transplantation as salvage treatment for AIDS-related lymphoma : Long-term results of the Italian Cooperative Group on AIDS and Tumors (GICAT) study with analysis of prognostic factors. / Re, Alessandro; Michieli, Mariagrazia; Casari, Salvatore; Allione, Bernardino; Cattaneo, Chiara; Rupolo, Maurizio; Spina, Michele; Manuele, Rosa; Vaccher, Emanuela; Mazzucato, Mario; Abbruzzese, Luciano; Ferremi, Pierino; Carosi, Giampiero; Tirelli, Umberto; Rossi, Giuseppe.

In: Blood, Vol. 114, No. 7, 2009, p. 1306-1313.

Research output: Contribution to journalArticle

Re, Alessandro ; Michieli, Mariagrazia ; Casari, Salvatore ; Allione, Bernardino ; Cattaneo, Chiara ; Rupolo, Maurizio ; Spina, Michele ; Manuele, Rosa ; Vaccher, Emanuela ; Mazzucato, Mario ; Abbruzzese, Luciano ; Ferremi, Pierino ; Carosi, Giampiero ; Tirelli, Umberto ; Rossi, Giuseppe. / High-dose therapy and autologous peripheral blood stem cell transplantation as salvage treatment for AIDS-related lymphoma : Long-term results of the Italian Cooperative Group on AIDS and Tumors (GICAT) study with analysis of prognostic factors. In: Blood. 2009 ; Vol. 114, No. 7. pp. 1306-1313.
@article{236b1f2560b94d4394d867523eb61421,
title = "High-dose therapy and autologous peripheral blood stem cell transplantation as salvage treatment for AIDS-related lymphoma: Long-term results of the Italian Cooperative Group on AIDS and Tumors (GICAT) study with analysis of prognostic factors",
abstract = "After the introduction of highly active antiretroviral therapy (HAART), intensive treatment, including high-dose therapy (HDT) and peripheral blood stem cell transplantation (PBSCT), has become feasible in HIV-positive patients with Hodgkin (HL) and non-Hodgkin (NHL) lymphoma. Herein, we report the long-term results, on an intention-to-treat basis, of a prospective study on HDT and PBSCT in 50 HIV-positive HAART-responding patients with refractory/relapsed lymphoma. After debulking therapy, 2 patients had early toxic deaths, 10 had chemoresistant disease, 6 failed stem cell mobilization, 1 refused collection, and 4 progressed soon after PBSC harvest. Twenty-seven actually received transplant. Twenty-one patients are alive and disease-free after a median follow-up of 44 months (OS, 74.6{\%}; PFS, 75.9{\%}). Only lymphoma response significantly affected OS after transplantation. In multivariate analyses both lymphoma stage and low CD4 count negatively influenced the possibility to receive transplant. Median OS of all 50 eligible patients was 33 months (OS, 49.8{\%}; PFS, 48.9{\%}). Low CD4 count, marrow involvement, and poor performance status independently affected survival. PBSCT is a highly effective salvage treatment for chemosensitive AIDS-related lymphoma. It seems rational to explore its use earlier during the course of lymphoma to increase the proportion of patients who can actually receive transplant.",
author = "Alessandro Re and Mariagrazia Michieli and Salvatore Casari and Bernardino Allione and Chiara Cattaneo and Maurizio Rupolo and Michele Spina and Rosa Manuele and Emanuela Vaccher and Mario Mazzucato and Luciano Abbruzzese and Pierino Ferremi and Giampiero Carosi and Umberto Tirelli and Giuseppe Rossi",
year = "2009",
doi = "10.1182/blood-2009-02-202762",
language = "English",
volume = "114",
pages = "1306--1313",
journal = "Blood",
issn = "0006-4971",
publisher = "American Society of Hematology",
number = "7",

}

TY - JOUR

T1 - High-dose therapy and autologous peripheral blood stem cell transplantation as salvage treatment for AIDS-related lymphoma

T2 - Long-term results of the Italian Cooperative Group on AIDS and Tumors (GICAT) study with analysis of prognostic factors

AU - Re, Alessandro

AU - Michieli, Mariagrazia

AU - Casari, Salvatore

AU - Allione, Bernardino

AU - Cattaneo, Chiara

AU - Rupolo, Maurizio

AU - Spina, Michele

AU - Manuele, Rosa

AU - Vaccher, Emanuela

AU - Mazzucato, Mario

AU - Abbruzzese, Luciano

AU - Ferremi, Pierino

AU - Carosi, Giampiero

AU - Tirelli, Umberto

AU - Rossi, Giuseppe

PY - 2009

Y1 - 2009

N2 - After the introduction of highly active antiretroviral therapy (HAART), intensive treatment, including high-dose therapy (HDT) and peripheral blood stem cell transplantation (PBSCT), has become feasible in HIV-positive patients with Hodgkin (HL) and non-Hodgkin (NHL) lymphoma. Herein, we report the long-term results, on an intention-to-treat basis, of a prospective study on HDT and PBSCT in 50 HIV-positive HAART-responding patients with refractory/relapsed lymphoma. After debulking therapy, 2 patients had early toxic deaths, 10 had chemoresistant disease, 6 failed stem cell mobilization, 1 refused collection, and 4 progressed soon after PBSC harvest. Twenty-seven actually received transplant. Twenty-one patients are alive and disease-free after a median follow-up of 44 months (OS, 74.6%; PFS, 75.9%). Only lymphoma response significantly affected OS after transplantation. In multivariate analyses both lymphoma stage and low CD4 count negatively influenced the possibility to receive transplant. Median OS of all 50 eligible patients was 33 months (OS, 49.8%; PFS, 48.9%). Low CD4 count, marrow involvement, and poor performance status independently affected survival. PBSCT is a highly effective salvage treatment for chemosensitive AIDS-related lymphoma. It seems rational to explore its use earlier during the course of lymphoma to increase the proportion of patients who can actually receive transplant.

AB - After the introduction of highly active antiretroviral therapy (HAART), intensive treatment, including high-dose therapy (HDT) and peripheral blood stem cell transplantation (PBSCT), has become feasible in HIV-positive patients with Hodgkin (HL) and non-Hodgkin (NHL) lymphoma. Herein, we report the long-term results, on an intention-to-treat basis, of a prospective study on HDT and PBSCT in 50 HIV-positive HAART-responding patients with refractory/relapsed lymphoma. After debulking therapy, 2 patients had early toxic deaths, 10 had chemoresistant disease, 6 failed stem cell mobilization, 1 refused collection, and 4 progressed soon after PBSC harvest. Twenty-seven actually received transplant. Twenty-one patients are alive and disease-free after a median follow-up of 44 months (OS, 74.6%; PFS, 75.9%). Only lymphoma response significantly affected OS after transplantation. In multivariate analyses both lymphoma stage and low CD4 count negatively influenced the possibility to receive transplant. Median OS of all 50 eligible patients was 33 months (OS, 49.8%; PFS, 48.9%). Low CD4 count, marrow involvement, and poor performance status independently affected survival. PBSCT is a highly effective salvage treatment for chemosensitive AIDS-related lymphoma. It seems rational to explore its use earlier during the course of lymphoma to increase the proportion of patients who can actually receive transplant.

UR - http://www.scopus.com/inward/record.url?scp=70349328418&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=70349328418&partnerID=8YFLogxK

U2 - 10.1182/blood-2009-02-202762

DO - 10.1182/blood-2009-02-202762

M3 - Article

C2 - 19451551

AN - SCOPUS:70349328418

VL - 114

SP - 1306

EP - 1313

JO - Blood

JF - Blood

SN - 0006-4971

IS - 7

ER -