HIV-associated lymphoma successfully treated with peripheral blood stem cell transplantation.
OBJECTIVE
To evaluate feasibility, safety, and efficacy of peripheral blood stem cell collection (PBSCC) and autologous stem cell transplantation (ASCT), to treat patients diagnosed of high-risk or relapsed HIV-associated lymphoma (HIV+ Ly), responding to highly active antiretroviral therapy (HAART).


METHODS
Prospective and multicentric study in patients with high-risk or relapsed chemosensitive HIV+ Ly, candidate for consolidation with ASCT. Eligibility criteria were similar to those of HIV- lymphoma. HAART was aimed to be maintained during the procedure.


RESULTS
Fourteen patients were admitted. Adequate PBSCC was obtained from all patients (median CD34+ cells was 4.7 x 10(6)/kg). Three patients died before ASCT; two had disease progression and one died from VHC-liver failure. Eleven transplanted patients showed neutrophil engraftment after a median time of 16 days (range, 9-33 days), and nine patients showed platelet engraftment after a median time of 20 days (range, 11-36 days). CD4+ cell counts and HIV viral load (VL) were appropriately preserved along the procedure. No patients died from treatment-related complications. One patient died from lymphoma progression (day +19), and another died in complete remission (CR) with undetectable VL, 15 months after transplant, due to infection. One patient relapsed at 32 months after ASCT. The remaining eight patients are alive in CR with an event-free survival of 65% and a median follow-up of 30 months after ASCT (range, 7-36 months).


CONCLUSIONS
These results show that feasibility, safety, and efficacy of PBSCC and ASCT in HIV+ Ly patients responding to HAART are similar to those observed in the HIV- lymphoma setting.
Serrano
David
D
Bone Marrow Transplantation Unit and Haematology Department, Hospital G. U. Gregorio Marañón, Madrid, Spain.
Carrión
Rafael
R
Balsalobre
Pascual
P
Miralles
Pilar
P
Berenguer
Juan
J
Buño
Ismael
I
Gómez-Pineda
Alfonso
A
Ribera
José M
JM
Conde
Eulogio
E
Díez-Martín
José L
JL
D000328:Adult; D018952:Antigens, CD34; D023241:Antiretroviral Therapy, Highly Active; D006085:Graft Survival; D006801:Humans; D008137:Longitudinal Studies; D016483:Lymphoma, AIDS-Related / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D036102:Peripheral Blood Stem Cell Transplantation / Q000379:methods*; D012074:Remission Induction; D016019:Survival Analysis; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D019562:Viral Load
D018952:Antigens, CD34