This single-institution analysis appears to indicate that there is an increasing incidence of patients with lung cancer and HIV infection. Patients with advanced NSCLC who are HIV positive with CD4 counts >200 can be treated with chemotherapy and demonstrate survival comparable to that of patients without HIV infection.

Post-transplant lymphoproliferative disorders (PTLD) complicate up to 10% of solid organ transplants. This retrospective study was conducted to review the PTLD experience among 2,300 recipients of solid organ or allogeneic bone marrow transplants from a single institution. Twenty-seven cases of PTLD were identified, leading to an overall incidence of 1.2%. Polymorphic B cell hyperplasia/lymphoma was the most common type. The median time to development of PTLD was 8.4 months. Ten patients had localized (stage I or II) disease, and 12 patients presented with B symptoms. Nine patients each were treated with systemic chemotherapy or surgical resection as part of the initial therapy. After a median follow-up duration of 2.6 years, the median survival has not been reached. There were no late relapses of PTLD, and 17 patients remain alive. Age, sex, organ source, LDH, stage, presence of extranodal disease, or presentation with B symptoms did not influence overall survival when examined by Cox proportional hazard model. Thirteen patients retained their graft function throughout PTLD treatment. This study confirms the ability to treat a significant proportion of PTLD patients with chemotherapy or surgical resection (depending on presentation), without sacrificing graft function in those receiving chemotherapy. Am. J. Hematol. 82:208-214, 2007. V V C 2006 Wiley-Liss, Inc.

Summary:Relapse remains a major cause of treatment failure after autotransplantation (auto-PBSCT) for Hodgkin's disease (HD). The administration of non-crossresistant therapies during the post-transplant period may delay or prevent relapse. We prospectively studied the role of consolidation chemotherapy (CC) after auto-PBSCT in 37 patients with relapsed or refractory HD. Patients received high-dose gemcitabine-BCNU-melphalan and auto-PBSCT followed by involved-field radiation and up to four cycles of the DCEP-G regimen, which consisted of dexamethasone, cyclophosphamide, etoposide, cisplatin, gemcitabine given at 3 and 9 months post transplant alternating with a second regimen (DPP) of dexamethasone, cisplatin, paclitaxel at 6 and 12 months post transplant. The probabilities of event-free survival (EFS) and overall survival (OS) at 2.5 years were 59% (95% CI ¼ 42-76%) and 86% (95% CI ¼ 71-99%), respectively. In all, 17 patients received 54 courses of CC and 15 were surviving event free (2.5 years, EFS ¼ 87%). There were no treatment-related deaths during or after the CC phase. Post-transplant CC is feasible and well tolerated. The impact of this approach on EFS should be evaluated in a larger, randomized study. PBSCT; auto-PBSCT; high-dose therapy; consolidation chemotherapy; gemcitabine High-dose therapy followed by autologous stem cell rescue has improved the long-term event-free (EFS) and overall survival (OS) for patients with relapsed or refractory Hodgkin's disease (HD). The probability of 5-year progression-free survival (PFS) for patients with HD autografted in first relapse ranged from 37 to 63% in selected series, while the PFS for patients autografted for primary refractory disease ranged from 15 to 50%. From these studies, predictors of better outcome after autotransplantation varied, but included 'minimal' disease status, chemosensitivity, normal LDH levels, good performance status, transplant in first relapse, absence of B symptoms at diagnosis, and administration of involvedfield radiotherapy post transplantation. In addition, factors identified by the International Prognostic Factors Project on advanced HD including low serum albumin, anemia, advanced age, and lymphocytopenia were associated with inferior EFS and OS rates after autotransplantation as well. 23 The chief cause of treatment failure after autotransplantation is relapse or progression of disease, which occurs in about 50% of transplanted patients. The majority of relapses occur in sites of prior disease but new and unusual sites of recurrence have been described including the leptomeninges. 11 To prevent or delay disease relapse after auto-PBSCT, a clinical protocol was developed that contained the following novel features: (1) the standard BEAM (BCNU-etoposide-cytarabine-melphalan) conditioning regimen was modified to include gemcitabine because of its single-agent activity in relapsed/refractory HD; 24 (2) dose-intensive cyclophosphamide and etoposide were used for pre-transplant cytoreduction and stem cell mobilization; (3) involv...

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