Syngeneic Bone Marrow Transplantation and Adoptive Transfer of Peripheral Blood Lymphocytes Combined with Zidovudine in Human Immunodeficiency Virus (HIV) Infection

Abstract

Although they establish the feasibility of combining zidovudine with cellular immune reconstitution in treating patients with HIV infection, our results show that any benefits from such combination therapy are at best transient. Future attempts at cellular immune reconstitution may need to use improved antiretroviral regimens as well as immunization of donors with HIV-specific antigens.

Late diversification in the clonal composition of human cytomegalovirus-specific CD8+ T cells following allogeneic hemopoietic stem cell transplantation

“…22,23 We found for the first time at a clonal level (using longitudinal clonotype probing to analyze CD8 ϩ T-cell reconstitution following alloSCT) that in 6 different sibling donor-recipient pairs when both donor and recipient were seropositive for either HCMV or EBV individual antigen-experienced virus-specific CD8 ϩ T-cell clones in donor PBMCs were transferred via the graft into the recipient where they are maintained long term. These clones obtained from the recipient months to years after transplantation were detectable at all early and late time points tested (up to 6 years) and were capable of in vitro proliferation (at least 12 doublings in LDA culture) and antigen-specific cytotoxicity.…”

Hematopoietic stem cell transplantation for HIV cure

“…Moreover, since the transduced stem cells have no intrinsic selective advantage compared with untransduced host cells, interruption of ART may be required to allow HIV replication to eliminate unmodified, HIV-susceptible CD4 + T cells in order for the progeny of the modified stem cells to become preBy contrast, HIV remained readily detectable by culture or by PCR in patients who received HSCT from syngeneic donors. The largest such experience involved infusion of peripheral blood lymphocytes followed by BM transplantation in 16 HIV-infected patients; donors were HIV-uninfected identical twins (13). After transplantation, patients were randomized to receive zidovudine or placebo.…”

Bone Marrow Transplantation for Nonmalignant Diseases

“…One patient had xenotransplantation with baboon marrow (90). In few patients, human immunodeficiency virus (HIV) was undetectable by PCR analysis (91,92), and 1 patient had transient PCR-negative status up to 120 days post transplantation (93). The role of transplantation in AIDS and HIV infection is currently not defined, and should probably be further studied in controlled clinical trials.…”