1. Feasibility and Efficacy of High-Dose Chemotherapy and Autologous Hematopoietic Cell Transplantation for HIV-Associated Lymphoma: A Single-Institution Experience.
- Author
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Ayala E, Chavez JC, Gomez A, Sleiman E, Kumar A, and Kharfan-Dabaja MA
- Subjects
- Adult, Antineoplastic Combined Chemotherapy Protocols adverse effects, Antiretroviral Therapy, Highly Active, Disease Progression, Feasibility Studies, Female, Florida, HIV isolation & purification, Hodgkin Disease diagnosis, Hodgkin Disease mortality, Hodgkin Disease virology, Humans, Lymphoma, AIDS-Related diagnosis, Lymphoma, AIDS-Related mortality, Lymphoma, AIDS-Related virology, Lymphoma, Non-Hodgkin diagnosis, Lymphoma, Non-Hodgkin mortality, Lymphoma, Non-Hodgkin virology, Male, Middle Aged, Progression-Free Survival, Retrospective Studies, Risk Factors, Time Factors, Transplantation, Autologous, Viral Load, Antineoplastic Combined Chemotherapy Protocols administration & dosage, Hematopoietic Stem Cell Transplantation adverse effects, Hematopoietic Stem Cell Transplantation mortality, Hodgkin Disease therapy, Lymphoma, AIDS-Related therapy, Lymphoma, Non-Hodgkin therapy
- Abstract
Background: HIV-associated lymphomas (HAL) remain an important cause of morbidity and mortality in HIV patients, especially in the setting of treatment-refractory disease. Hematopoietic cell transplantation (HCT) is considered a curative option for patients with refractory HAL., Patients and Methods: We report the efficacy of autologous HCT in 20 patients with HAL [non-Hodgkin lymphoma = 14 (70%), Hodgkin lymphoma = 6 (30%)]. At the time of transplantation, the median peripheral blood CD4
+ count was 226 cells/μL. HIV virus load was undetectable in 14 (70%) of 20 patients., Results: The median follow-up of surviving patients was 47 months (range, 20-119 months). The median time to neutrophil engraftment was 11 days. The median progression-free survival and median overall survival have not been reached. At 4 years after transplantation, progression-free survival and overall survival were 65% and 70%, respectively. Six patients died from disease relapse or progression (n = 5) and infection (n = 1). Nonrelapse mortality was 0 and 5% at 100 days and 4 years after transplantation, respectively., Conclusion: Autologous HCT is an effective therapy for refractory/relapsed HAL with manageable toxicity, similar to non-HIV patients., (Copyright © 2018 Elsevier Inc. All rights reserved.)- Published
- 2018
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