Should HIV-positive patients with lymphoma be offered stem cell transplants?

Krishnan, Amrita; Zaia, John A.; Forman, Stephen J.

doi:10.1038/sj.bmt.1704270

Cited by 16 publications

(12 citation statements)

References 34 publications

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“…Infectious complications were comparable with those that have been reported in the HIV-negative NHL patients who underwent ASCT and no long-term deterioration in immune function was noted. Several studies have reported success in the treatment of relapsed ARL using second-line therapy followed by HDCT and ASCT [50–52]. Among 68 ARL patients who underwent HDCT/ASCT from 20 institutions across Europe between the years 1999 and 2004, the PFS and OS were 56.5% and 61%, respectively, at a median followup of 32 months [53].…”

Section: Treatment Of Relapsed Arlmentioning

confidence: 99%

AIDS-Related Non-Hodgkin's Lymphoma in the Era of Highly Active Antiretroviral Therapy

Vishnu

Aboulafia

2012

Advances in Hematology

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In economically developed countries, AIDS-related lymphoma (ARL) accounts for a large proportion of malignances in HIV-infected individuals. Since the introduction of highly active anti-retroviral therapy (HAART) in 1996, epidemiology and prognosis of ARL have changed. While there is a slight increase in the incidence of Hodgkin’s lymphoma in HIV-infected individuals, use of HAART has contributed to a decline in the incidence of non-Hodgkin’s lymphoma (NHL) and also a decrease in the overall incidence of ARL. Strategies that employ HAART, improved supportive care, and the use of Rituximab with multi-agent chemotherapy have contributed to improved rates of complete remission and survival of patients with ARL that rival those seen in stage and histology matched HIV negative NHL patients. Most recent clinical trials demonstrate better outcomes with the use of rituximab in ARL. Tumor histogenesis (germinal center vs. non-germinal center origin) is associated with lymphoma-specific outcomes in the setting of AIDS-related diffuse-large B cell lymphoma. High-dose chemotherapy (HDCT) and autologous stem cell rescue (ASCT) can be effective for a subset of patients with relapsed ARL. HIV sero-status alone should not preclude consideration of ASCT in the setting of ARL relapse. Clinical trials investigating the role of allogeneic hematopoietic stem cell transplant in ARL are currently underway.

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Section: Treatment Of Relapsed Arlmentioning

confidence: 99%

AIDS-Related Non-Hodgkin's Lymphoma in the Era of Highly Active Antiretroviral Therapy

Vishnu

Aboulafia

2012

Advances in Hematology

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“…HAART therapy is feasible throughout the transplant process [129]. In one report, 16 of 19 patients remained in remission after 2 years of follow-up [130].…”

Section: Treatmentmentioning

confidence: 99%

AIDS-Related Malignancies: Emerging Challenges in the Era of Highly Active Antiretroviral Therapy

2005

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Human immunodeficiency virus (HIV)-infected patients are at increased risk of developing cancer, particularly in the later stages of acquired immune deficiency syndrome (AIDS). LEARNING OBJECTIVESAfter completing this course, the reader will be able to:1. Describe the pathogenesis and clinical presentation of Kaposi's sarcoma, with a special emphasis on Kaposi's sarcoma herpesvirus/human herpesvirus-8, and outline treatment approaches.2. Discuss the pathogenesis, epidemiology, and treatment of AIDS-related lymphomas.3. Discuss the increasing incidence of non-AIDS-defining malignancies such as Hodgkin's lymphoma and plasma cell disorders in patients with HIV infection.4. Explain how, in the era of highly active antiretroviral therapy, both AIDS-related lymphoma and Hodgkin's lymphoma patients may be treated with therapies previously reserved for their immunocompetent counterparts.Access and take the CME test online and receive 1 hour of AMA PRA category 1 credit at CME.TheOncologist.com CME CME by guest on May 11, 2018http://theoncologist.alphamedpress.org/ Downloaded fromThis material is protected by U.S.

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“…Krishnan et al [20] reviewed autologous transplantation for HIV-1-positive patients with lymphoma, and concluded that high-dose therapy with autologous stem cell rescue is feasible in HIV-1-infected patients with lymphoma following HAART. During chemotherapy, in combination with HAART, prompt reduction of HIV-1 load was reported [21,22].…”

Section: Discussionmentioning

confidence: 98%

Successful unrelated bone marrow transplantation for a human immunodeficiency virus type-1-seropositive acute myelogenous leukemia patient following HAART

et al. 2009

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The availability of highly active anti-retroviral therapy (HAART) has greatly improved the outcome of human immunodeficiency virus type-1 (HIV-1) infection and disease. We report here on a case of an HIV-1-seropositive patient with acute myelogenous leukemia who underwent a successful allogeneic unrelated bone marrow transplantation following HAART. A 40-year-old Japanese HIV-seropositive man underwent allogeneic unrelated bone marrow transplantation using a myeloablative pretransplant-conditioning regimen. Neutrophil engraftment occurred on day +18, and donor chimerism was achieved on day +27. During pre- and post- transplantation, the HAART was not interrupted. Over 1 year after transplantation, the patient is alive and in continuous complete remission with undetectable levels of HIV-1 RNA. HAART can lead to a successful hematopoietic stem cell transplantation without severe opportunistic infections.

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Should HIV-positive patients with lymphoma be offered stem cell transplants?

Cited by 16 publications

References 34 publications

AIDS-Related Non-Hodgkin's Lymphoma in the Era of Highly Active Antiretroviral Therapy

AIDS-Related Non-Hodgkin's Lymphoma in the Era of Highly Active Antiretroviral Therapy

AIDS-Related Malignancies: Emerging Challenges in the Era of Highly Active Antiretroviral Therapy

Successful unrelated bone marrow transplantation for a human immunodeficiency virus type-1-seropositive acute myelogenous leukemia patient following HAART

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