title: Postautologous stem cell transplantation long-term outcomes in 26 HIV-positive patients affected by relapsed/refractory lymphoma.
abstract: OBJECTIVE
  To describe survival data, CD4 T-cell long-term dynamics and the correlation between dynamics and events occurrence in 26 HIV-positive patients with refractory lymphoma in complete response after autologous stem cell transplantation (ASCT).
  
  
  METHODS
  Retrospective single-centre study.
  
  
  METHODS
  Lymphoma relapse, second cancers and opportunistic infections were considered after ASCT. Group A included patients experiencing events after ASCT and group B the remaining patients. Overall survival, progression-free survival and event-free survival probabilities were estimated by Kaplan-Meier method. The comparison of median CD4 T-cell count at cancer diagnosis with matched values was investigated by Wilcoxon signed-rank test and between group A and B by Mann-Whitney U test.
  
  
  RESULTS
  With a median of 6-year follow-up, the overall survival, the progression-free survival and the event-free survival at 10 years were 91, 86 and 36%. Compared with CD4 T-cell count at cancer diagnosis a higher amount was maintained over time after ASCT. Two patients experienced a lymphoma relapse at 4.3 and 3.1 years; five patients had secondary malignancies and nine patients opportunistic infections at a median time of 2.2 and 0.4 years from ASCT. At 6 and 12 months after ASCT, a significant difference in CD4 T-cell count was found between group A and B.
  
  
  CONCLUSIONS
  ASCT has a dramatic impact on survival of HIV-positive patients with refractory lymphoma. We support surveillance of opportunistic infections early after ASCT and of second cancers or lymphoma relapses later from ASCT. Both opportunistic infections and second malignancies were successfully managed and the only long-term death occurred due to lymphoma relapse. ASCT seems to contribute to immune recovery.
authors.affiliation: aUnit of Cell Therapy and High Dose Chemotherapy bUnit of Epidemiology and Biostatistics cUnit of Stem Cells Collection and Processing dUnit of Microbiology-Immunology and Virology eScientific Directorate fDivision of Medical Oncology A, CRO Aviano National Cancer Institute, Aviano, Italy.
authors.forename: Ernesto
authors.initials: E
authors.lastname: Zanet
authors.forename: Martina
authors.initials: M
authors.lastname: Taborelli
authors.forename: Maurizio
authors.initials: M
authors.lastname: Rupolo
authors.forename: Cristina
authors.initials: C
authors.lastname: Durante
authors.forename: Mario
authors.initials: M
authors.lastname: Mazzucato
authors.forename: Stefania
authors.initials: S
authors.lastname: Zanussi
authors.forename: Paolo
authors.initials: P
authors.lastname: De Paoli
authors.forename: Diego
authors.initials: D
authors.lastname: Serraino
authors.forename: Umberto
authors.initials: U
authors.lastname: Tirelli
authors.forename: Arben
authors.initials: A
authors.lastname: Lleshi
authors.forename: Mariagrazia
authors.initials: M
authors.lastname: Michieli
mesh_terms: D018791:CD4 Lymphocyte Count; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D008223:Lymphoma / Q000628:therapy*; D008297:Male; D012189:Retrospective Studies; D033581:Stem Cell Transplantation; D016019:Survival Analysis; D014182:Transplantation, Autologous; D016896:Treatment Outcome