Allogeneic bone marrow transplantation combined with multiple anti-HIV-1 treatment in a case of AIDS.
A 25-year-old woman with AIDS was submitted to HLA-identical allogeneic BMT after cytoablation with busulphan and cyclophosphamide and combined anti-HIV-1 therapy with zidovudine, IFN-alpha 2 and anti-HIV-1-specific T cell clones. Marrow engraftment occurred after 18 days and tests for HIV-1 were negative after 30 days but the hematologic reconstitution of the patient was poor. A second BM infusion from the same donor was ineffective and treatment with GM-CSF only induced a transient increase of the blood cell count, suggesting iatrogenic damage to the BM microenvironment. The development of ARDS led to the death of the patient 10 months after transplantation. Post-mortem investigation did not reveal any active infections and PCR on autopsy tissues was negative for HIV-1.
Contu
L
L
Istituto di Clinica Medica, Università di Cagliari, Italy.
La Nasa
G
G
Arras
M
M
Pizzati
A
A
Vacca
A
A
Carcassi
C
C
Ledda
A
A
Boero
R
R
Orrù
S
S
Pintus
A
A
D000163:Acquired Immunodeficiency Syndrome / Q000276:immunology / Q000601:surgery* / Q000628:therapy; D000328:Adult; D000961:Antilymphocyte Serum / Q000008:administration & dosage; D016026:Bone Marrow Transplantation / Q000009:adverse effects / Q000276:immunology / Q000379:methods; D002066:Busulfan / Q000008:administration & dosage; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000008:administration & dosage; D004359:Drug Therapy, Combination; D005260:Female; D006086:Graft vs Host Disease / Q000276:immunology; D016178:Granulocyte-Macrophage Colony-Stimulating Factor / Q000008:administration & dosage; D015497:HIV-1 / Q000302:isolation & purification; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000008:administration & dosage; D011994:Recombinant Proteins; D012128:Respiratory Distress Syndrome / Q000209:etiology; D014184:Transplantation, Homologous; D015215:Zidovudine / Q000008:administration & dosage
D000961:Antilymphocyte Serum; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D015215:Zidovudine; D016178:Granulocyte-Macrophage Colony-Stimulating Factor; D003520:Cyclophosphamide; D002066:Busulfan