Faculty Collaboration Database

Allogeneic hematopoietic cell transplantation in human immunodeficiency virus-positive patients with hematologic disorders: a report from the center for international blood and marrow transplant research. Biol Blood Marrow Transplant 2009 Jul;15(7):864-71

Date

06/23/2009

Pubmed ID

19539219

Pubmed Central ID

PMC2881828

DOI

10.1016/j.bbmt.2009.03.023

Scopus ID

2-s2.0-66949130694 (requires institutional sign-in at Scopus site)   49 Citations

Abstract

The role of allogeneic hematopoietic cell transplantation (alloHCT) in human immunodeficiency virus (HIV)-positive patients is not known. Using the Center for International Blood and Marrow Transplant Research database, we retrospectively evaluated 23 HIV-positive patients undergoing matched sibling donor (n = 19) or unrelated donor (n = 4) alloHCT between 1987 and 2003. The median age at alloHCT was 32 years. Indications for alloHCT were diverse and included malignant (n = 21) and nonmalignant (n = 2) hematologic disorders. Nine patients (39%) underwent transplantation after 1996, the approximate year that highly active antiretroviral therapy became standard treatment. The median time to neutrophil engraftment was 16 days (range, 7 to 30 days), and the cumulative incidences of grade II-IV acute graft-versus-host disease (aGVHD) at 100 days, chronic GVHD (cGVHD), and survival at 2 years were 30% (95% confidence interval [CI] = 14% to 50%), 28% (95% CI = 12% to 48%), and 30% (95% CI = 14% to 50%), respectively. At a median follow-up of 59 months, 6 patients were alive. Survival appears to be better in the patients undergoing alloHCT after 1996; 4 of these 9 patients survived, compared with only 2 of 14 those undergoing transplantation before 1996. These data suggest that alloHCT is feasible for selected HIV-positive patients with malignant and nonmalignant disorders. Prospective studies are needed to evaluate the safety and efficacy of this modality in specific diseases in these patients.

Author List

Gupta V, Tomblyn M, Pedersen TL, Atkins HL, Battiwalla M, Gress RE, Pollack MS, Storek J, Thompson JC, Tiberghien P, Young JA, Ribaud P, Horowitz MM, Keating A

Author

Mary M. Horowitz MD, MS Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Acute Disease
Adolescent
Adult
Antiretroviral Therapy, Highly Active
Child
Chronic Disease
Disease-Free Survival
Female
Graft Survival
Graft vs Host Disease
HIV Seropositivity
Hematologic Diseases
Hematopoietic Stem Cell Transplantation
Humans
Male
Retrospective Studies
Survival Rate
Time Factors
Transplantation, Homologous