TY - JOUR
T1 - High-dose therapy plus autologous hematopoietic stem cell transplantation for human immunodeficiency virus (HIV)-related lymphoma
T2 - Results and impact on HIV disease
AU - Gabarre, Jean
AU - Marcelin, Anne Geneviève
AU - Azar, Nabih
AU - Choquet, Sylvain
AU - Lévy, Vincent
AU - Lévy, Yves
AU - Tubiana, Roland
AU - Charlotte, Frédéric
AU - Norol, Françoise
AU - Calvez, Vincent
AU - Spina, Michele
AU - Vernant, Jean Paul
AU - Autran, Brigitte
AU - Leblond, Véronique
PY - 2004/9
Y1 - 2004/9
N2 - Background and Objectives. The aim of this study was to assess the feasibility of high-dose chemotherapy plus autologous hematopoietic stem cell transplantation (HDC/AHSCT) in AIDS-related lymphoma (ARL), and its long-term impact in patients with human immunodeficiency virus (HIV) treated with highly active antiretroviral therapy (HAART). Design and Methods. Fourteen patients with relapsed or resistant ARL (8 with non-Hodgkin's lymphoma and 6 with Hodgkin's disease) were treated with HDC/AHSCT while on HAART. HIV-1 proviral DNA load was quantified in 11 grafts. Results. Hematologic reconstitution was good. No toxic deaths occurred. Despite the large number of cells harboring HIV-1 proviral DNA (105 to 109) re-infused with the graft, HAART controlled HIV replication and led to CD4 cell reconstitution in 7 of the 8 patients who were still alive six months after AHSCT. Only two patients had opportunistic infections after AHSCT. There were no significant changes in viral load (VL) or CD4+ cell counts in most patients. One month after AHSCT, 10 patients were in complete remission (CR). Seven patients died from lymphoma between 1 and 10 months after AHSCT, and a further two patients died in CR (one from AIDS at 16 months, one from another tumor at 28 months). Five patients are alive: four are in CR, 14, 19, 32 and 49 months after AHSCT (median CD4+ cell count= 445/μL; undetectable VL in 3 patients), and one is being treated for relapsed lymphoma 36 months after AHSCT. Interpretations and Conclusions. HDC/AHSCT is feasible in AIDS-related lymphoma, in terms of harvesting, engraftment, adverse events and HIV control. It should be proposed to patients with poor-prognosis chemosensitive lymphoma.
AB - Background and Objectives. The aim of this study was to assess the feasibility of high-dose chemotherapy plus autologous hematopoietic stem cell transplantation (HDC/AHSCT) in AIDS-related lymphoma (ARL), and its long-term impact in patients with human immunodeficiency virus (HIV) treated with highly active antiretroviral therapy (HAART). Design and Methods. Fourteen patients with relapsed or resistant ARL (8 with non-Hodgkin's lymphoma and 6 with Hodgkin's disease) were treated with HDC/AHSCT while on HAART. HIV-1 proviral DNA load was quantified in 11 grafts. Results. Hematologic reconstitution was good. No toxic deaths occurred. Despite the large number of cells harboring HIV-1 proviral DNA (105 to 109) re-infused with the graft, HAART controlled HIV replication and led to CD4 cell reconstitution in 7 of the 8 patients who were still alive six months after AHSCT. Only two patients had opportunistic infections after AHSCT. There were no significant changes in viral load (VL) or CD4+ cell counts in most patients. One month after AHSCT, 10 patients were in complete remission (CR). Seven patients died from lymphoma between 1 and 10 months after AHSCT, and a further two patients died in CR (one from AIDS at 16 months, one from another tumor at 28 months). Five patients are alive: four are in CR, 14, 19, 32 and 49 months after AHSCT (median CD4+ cell count= 445/μL; undetectable VL in 3 patients), and one is being treated for relapsed lymphoma 36 months after AHSCT. Interpretations and Conclusions. HDC/AHSCT is feasible in AIDS-related lymphoma, in terms of harvesting, engraftment, adverse events and HIV control. It should be proposed to patients with poor-prognosis chemosensitive lymphoma.
KW - AIDS
KW - Autologous hematopoietic stem cell transplantation
KW - Chemotherapy
KW - HIV
KW - Lymphoma
UR - http://www.scopus.com/inward/record.url?scp=4644234161&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=4644234161&partnerID=8YFLogxK
M3 - Article
C2 - 15377471
AN - SCOPUS:4644234161
VL - 89
SP - 1100
EP - 1108
JO - Haematologica
JF - Haematologica
SN - 0390-6078
IS - 9
ER -