TY - JOUR
T1 - Autologous hematopoietic cell transplantation for HIV-related lymphoma
T2 - Results of the BMT CTN 0803/AMC 071 trial
AU - Alvarnas, Joseph C.
AU - Le Rademacher, Jennifer
AU - Wang, Yanli
AU - Little, Richard F.
AU - Akpek, Gorgun
AU - Ayala, Ernesto
AU - Devine, Steven
AU - Baiocchi, Robert
AU - Lozanski, Gerard
AU - Kaplan, Lawrence
AU - Noy, Ariela
AU - Popat, Uday
AU - Hsu, Jack
AU - Morris, Lawrence E.
AU - Thompson, Jason
AU - Horowitz, Mary M.
AU - Mendizabal, Adam
AU - Levine, Alexandra
AU - Krishnan, Amrita
AU - Forman, Stephen J.
AU - Navarro, Willis H.
AU - Ambinder, Richard
N1 - Funding Information:
This work is supported by grants from the National Institutes of Health National Cancer Institute (NCI; grant HHSN21200622012C- 009) and the AMC through NCI (grant U01CA121947). The Blood and Marrow Transplant Clinical Trials Network infrastructure is supported in part by the National Heart, Lung, and Blood Institute and NCI (grant U10HL069294).
Publisher Copyright:
Copyright 2011 by The American Society of Hematology; all rights reserved.
PY - 2016/8/25
Y1 - 2016/8/25
N2 - Autologous hematopoietic cell transplant (AHCT) for HIV-infected patients is largely limited to centers with HIV-specific expertise. The Blood and Marrow Transplant Clinical Trials Network 0803/AIDS Malignancy Consortium 071 trial is a multicenter phase 2 study of AHCT for patients with HIV-related lymphoma (HRL). Eligible patients had chemotherapy-sensitive relapsed/persistent HRL, were >15 years of age, and had treatable HIV infection. Patients were prepared using carmustine, etoposide, cytarabine, and melphalan and received consistent management of peritransplant antiretroviral treatment. The primary endpoint was 1-year overall survival. Forty-three patients were enrolled; 40 underwent AHCT. Pretransplant HIV viral load was undetectable (<50 copies/mL) in 32 patients (80%); the median CD4 count was 249/μL (range, 39-797). At a median follow-up-of 24.8 months, 1-year and 2-year overall survival probabilities were 87.3% (95% confidence interval [CI], 72.1-94.5) and 82% (95% CI, 65.9-91), respectively. The probability of 2-year progression-free survival was 79.8% (95% CI, 63.7-89.4). One-year transplant-related mortality was 5.2%. Median time to neutrophil and platelet recovery was 11 days and 18 days, respectively. Nine patients experienced a total of 13 unexpected grade 3-5 adverse events posttransplant (10 grade 3 and 3 grade 4 events). Twenty-two patients had atleast 1 infectious episode posttransplant. At 1 year post-AHCT, median CD4+T-cellcount was 280.3 (range, 28.8-1148.0);82.6% had an undetectable HIV viral load. Trial patients were compared with 151 matched Center for International Bone Marrow Transplant Research controls. Outcomes between HIV-infected patients and controls were not statistically significantly different. HRL patients should be considered candidates for AHCT if they meet standard transplant criteria.
AB - Autologous hematopoietic cell transplant (AHCT) for HIV-infected patients is largely limited to centers with HIV-specific expertise. The Blood and Marrow Transplant Clinical Trials Network 0803/AIDS Malignancy Consortium 071 trial is a multicenter phase 2 study of AHCT for patients with HIV-related lymphoma (HRL). Eligible patients had chemotherapy-sensitive relapsed/persistent HRL, were >15 years of age, and had treatable HIV infection. Patients were prepared using carmustine, etoposide, cytarabine, and melphalan and received consistent management of peritransplant antiretroviral treatment. The primary endpoint was 1-year overall survival. Forty-three patients were enrolled; 40 underwent AHCT. Pretransplant HIV viral load was undetectable (<50 copies/mL) in 32 patients (80%); the median CD4 count was 249/μL (range, 39-797). At a median follow-up-of 24.8 months, 1-year and 2-year overall survival probabilities were 87.3% (95% confidence interval [CI], 72.1-94.5) and 82% (95% CI, 65.9-91), respectively. The probability of 2-year progression-free survival was 79.8% (95% CI, 63.7-89.4). One-year transplant-related mortality was 5.2%. Median time to neutrophil and platelet recovery was 11 days and 18 days, respectively. Nine patients experienced a total of 13 unexpected grade 3-5 adverse events posttransplant (10 grade 3 and 3 grade 4 events). Twenty-two patients had atleast 1 infectious episode posttransplant. At 1 year post-AHCT, median CD4+T-cellcount was 280.3 (range, 28.8-1148.0);82.6% had an undetectable HIV viral load. Trial patients were compared with 151 matched Center for International Bone Marrow Transplant Research controls. Outcomes between HIV-infected patients and controls were not statistically significantly different. HRL patients should be considered candidates for AHCT if they meet standard transplant criteria.
KW - Autologous hematopoietic cell transplantation is safe and effective in patients with HIV-related lymphoma who meet standard transplant criteria.
KW - Patients with HIV-related lymphomas should not be precluded from participating in AHCT clinical trials
UR - http://www.scopus.com/inward/record.url?scp=84984815928&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84984815928&partnerID=8YFLogxK
U2 - 10.1182/blood-2015-08-664706
DO - 10.1182/blood-2015-08-664706
M3 - Article
C2 - 27297790
AN - SCOPUS:84984815928
SN - 0006-4971
VL - 128
SP - 1050
EP - 1058
JO - Blood
JF - Blood
IS - 8
ER -