title: Hematopoietic stem cell transplantation in HIV-1-infected individuals:  clinical challenges and the potential for viral eradication.
abstract: OBJECTIVE
  We will review the evidence that hematopoietic stem cell transplantation is well tolerated and effective in HIV-1-infected individuals with high-risk hematologic malignancies. We will discuss the challenges of using blood and marrow transplant strategies in this population, as well as the potential impact that hematopoietic stem cell transplantation has on HIV-1 reservoirs and persistence.
  
  
  RESULTS
  Advances in stem cell transplantation and the success of antiretroviral therapy (ART) have made it possible to extend curative cancer therapy to HIV-1-infected individuals with aggressive lymphoma and leukemia. Outcomes of autologous hematopoietic stem cell transplantation in HIV-1-infected individuals are similar to the general population. In allogeneic hematopoietic stem cell transplantation (alloHSCT), there are a growing number of successful case reports and the first national trial is ongoing. Infectious complications do not appear to be increased in patients on effective ART; however, drug interactions and drug interruptions are common. There is also renewed interest in the possibility that alloHSCT could lead to HIV-1 cure.
  
  
  CONCLUSIONS
  HIV-1 infection is not a contraindication to blood and marrow transplantation and may offer unique benefits. Particular attention to preventing infectious complications, drug interactions, and drug interruptions in this patient population is required.
authors: Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland 21087, USA.
authors: Christine M
authors: CM
authors: Durand
authors: Richard F
authors: RF
authors: Ambinder
mesh_terms: D004197:Disease Reservoirs; D015658:HIV Infections / Q000821:virology; D015497:HIV-1; D019337:Hematologic Neoplasms / Q000628:therapy*; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans