Abstract
Objective. To evaluate the safety, feasibility, and efficacy of allogeneic stem cell transplantation (SCT) for acute myelogenous leukemia (AML) in a young female coinfected by HIV and HCV undergoing highly active antiretroviral therapy (HAART). Patient and Methods. A 33-year-old female HIV+, HCV+ in complete remission after standard chemotherapy was submitted to CD34+ selected allogeneic transplantation from her HLA-identical HIV- brother after myeloablative regimen. HAART was started before transplantation, achieving a reduction of HIV load to undetectable levels. GVHD prophylaxis was carried out with cyclosporine A alone. Results. The patient achieved prompt and durable engraftment with acute GVHD grade II easily managed with steroids; CMV prophylaxis was prolonged, no clinically relevant infectious complications developed early after transplantation and during follow-up. HIV viremia was controlled by HAART although medication adherence was reduced early after transplantation and required drug adjustment. There was a gradual recovery of immune cells with normal CD4-cell count 39 months after engraftment, a significantly higher level than before transplantation. At 39 months posttranplantation follow-up the patient is alive and in continuous complete remission with undetectable levels of plasma HIV RNA on HAART. Conclusion. The introduction of HAART has recently changed the paradigm of AIDS, allowing the control of HIV replication, the reduction of opportunistic infections, and the overall improvement of survival. One may therefore reconsider the current exclusion of patients with AIDS and a concomitant lethal malignancy from programs of high-dose chemotherapy and stem cell transplation, as suggested by this report.
| Original language | English |
|---|---|
| Pages (from-to) | 279-284 |
| Number of pages | 6 |
| Journal | Experimental Hematology |
| Volume | 30 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - 2002 |
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ASJC Scopus subject areas
- Cancer Research
- Cell Biology
- Genetics
- Hematology
- Oncology
- Transplantation
Cite this
Highly active antiretroviral therapy and allogeneic CD34+ peripheral blood progenitor cells transplantation in an HIV/HCV coinfected patient with acute myeloid leukemia. / Sorà, Federica; Antinori, Andrea; Piccirillo, Nicola; De Luca, Andrea; Chiusolo, Patrizia; Cingolani, Antonella; Laurenti, Luca; Rutella, Sergio; Ortona, Luigi; Leone, Giuseppe; Sica, Simona.
In: Experimental Hematology, Vol. 30, No. 3, 2002, p. 279-284.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Highly active antiretroviral therapy and allogeneic CD34+ peripheral blood progenitor cells transplantation in an HIV/HCV coinfected patient with acute myeloid leukemia
AU - Sorà, Federica
AU - Antinori, Andrea
AU - Piccirillo, Nicola
AU - De Luca, Andrea
AU - Chiusolo, Patrizia
AU - Cingolani, Antonella
AU - Laurenti, Luca
AU - Rutella, Sergio
AU - Ortona, Luigi
AU - Leone, Giuseppe
AU - Sica, Simona
PY - 2002
Y1 - 2002
N2 - Objective. To evaluate the safety, feasibility, and efficacy of allogeneic stem cell transplantation (SCT) for acute myelogenous leukemia (AML) in a young female coinfected by HIV and HCV undergoing highly active antiretroviral therapy (HAART). Patient and Methods. A 33-year-old female HIV+, HCV+ in complete remission after standard chemotherapy was submitted to CD34+ selected allogeneic transplantation from her HLA-identical HIV- brother after myeloablative regimen. HAART was started before transplantation, achieving a reduction of HIV load to undetectable levels. GVHD prophylaxis was carried out with cyclosporine A alone. Results. The patient achieved prompt and durable engraftment with acute GVHD grade II easily managed with steroids; CMV prophylaxis was prolonged, no clinically relevant infectious complications developed early after transplantation and during follow-up. HIV viremia was controlled by HAART although medication adherence was reduced early after transplantation and required drug adjustment. There was a gradual recovery of immune cells with normal CD4-cell count 39 months after engraftment, a significantly higher level than before transplantation. At 39 months posttranplantation follow-up the patient is alive and in continuous complete remission with undetectable levels of plasma HIV RNA on HAART. Conclusion. The introduction of HAART has recently changed the paradigm of AIDS, allowing the control of HIV replication, the reduction of opportunistic infections, and the overall improvement of survival. One may therefore reconsider the current exclusion of patients with AIDS and a concomitant lethal malignancy from programs of high-dose chemotherapy and stem cell transplation, as suggested by this report.
AB - Objective. To evaluate the safety, feasibility, and efficacy of allogeneic stem cell transplantation (SCT) for acute myelogenous leukemia (AML) in a young female coinfected by HIV and HCV undergoing highly active antiretroviral therapy (HAART). Patient and Methods. A 33-year-old female HIV+, HCV+ in complete remission after standard chemotherapy was submitted to CD34+ selected allogeneic transplantation from her HLA-identical HIV- brother after myeloablative regimen. HAART was started before transplantation, achieving a reduction of HIV load to undetectable levels. GVHD prophylaxis was carried out with cyclosporine A alone. Results. The patient achieved prompt and durable engraftment with acute GVHD grade II easily managed with steroids; CMV prophylaxis was prolonged, no clinically relevant infectious complications developed early after transplantation and during follow-up. HIV viremia was controlled by HAART although medication adherence was reduced early after transplantation and required drug adjustment. There was a gradual recovery of immune cells with normal CD4-cell count 39 months after engraftment, a significantly higher level than before transplantation. At 39 months posttranplantation follow-up the patient is alive and in continuous complete remission with undetectable levels of plasma HIV RNA on HAART. Conclusion. The introduction of HAART has recently changed the paradigm of AIDS, allowing the control of HIV replication, the reduction of opportunistic infections, and the overall improvement of survival. One may therefore reconsider the current exclusion of patients with AIDS and a concomitant lethal malignancy from programs of high-dose chemotherapy and stem cell transplation, as suggested by this report.
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UR - http://www.scopus.com/inward/citedby.url?scp=18344365190&partnerID=8YFLogxK
U2 - 10.1016/S0301-472X(01)00793-7
DO - 10.1016/S0301-472X(01)00793-7
M3 - Article
C2 - 11882366
AN - SCOPUS:18344365190
VL - 30
SP - 279
EP - 284
JO - Experimental Hematology
JF - Experimental Hematology
SN - 0301-472X
IS - 3
ER -