title: T-cell immune reconstitution after hematopoietic stem cell transplantation for HIV-associated lymphoma.
abstract: BACKGROUND
  One of the major concern for high-dose chemotherapy and hematopoietic stem cell transplantation (HSCT) for HIV-associated lymphoma is that posttransplant immunosuppression might worsen immune defects of HIV individuals. Since the introduction of highly active antiretroviral therapy has made HSCT possible also in these patients, we analyzed whether the immune system already compromised by HIV infection might support an efficient T-cell recovery after HSCT.
  
  
  METHODS
  The kinetics and the extent of T-cell reconstitution were investigated before and after HSCT in four patients with HIV-related lymphoma (one with Hodgkin's Disease and three with non-Hodgkin's lymphoma) by measuring the thymic output, the level of IL-7 and the heterogeneity of T-cell repertoire. T-cell competence was gauged at two functional levels: by determining the number of T-cell divisions and by measuring IFN-gamma production.
  
  
  RESULTS
  The thymus of transplanted patients can be capable of generating new T cells, but there is no relationship between increasing number of newly produced lymphocytes and modification of IL-7 level. Various T-cell subsets, expressing different T-cell receptor variable beta genes, were preferentially expanded in CD8 population and most of them showed a restricted diversity. Furthermore, CD3 lymphocytes showed heterogeneous behaviors in terms of proliferative capability and IFN-gamma production.
  
  
  CONCLUSIONS
  High-dose therapy and HSCT in HIV patients under highly active antiretroviral therapy does not worsen the immune defects. On the contrary, in the presence of some conditions (including the type of hematologic malignancy, the therapy compliance, and the immune status before transplantation), high-dose therapy and HSCT might support the improvement of immune conditions.
authors.affiliation: Department of Laboratory Diagnostics, Terzo Laboratorio, Spedali Civili of Brescia, Italy.
authors.forename: Tiziana
authors.initials: T
authors.lastname: Benicchi
authors.forename: Claudia
authors.initials: C
authors.lastname: Ghidini
authors.forename: Alessandro
authors.initials: A
authors.lastname: Re
authors.forename: Chiara
authors.initials: C
authors.lastname: Cattaneo
authors.forename: Salvatore
authors.initials: S
authors.lastname: Casari
authors.forename: Luigi
authors.initials: L
authors.lastname: Caimi
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Rossi
authors.forename: Luisa
authors.initials: L
authors.lastname: Imberti
mesh_terms: D000328:Adult; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology*; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology*; D005434:Flow Cytometry; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D016483:Lymphoma, AIDS-Related / Q000276:immunology* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D016693:Receptors, Antigen, T-Cell, alpha-beta / Q000276:immunology; D020127:Recovery of Function / Q000276:immunology; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D014766:Viremia / Q000276:immunology / Q000628:therapy
chemical_list: D016693:Receptors, Antigen, T-Cell, alpha-beta