Graft-versus-leukaemia effect post fludarabine, melphalan and alemtuzumab reduced intensity allogeneic stem cell transplantat in HIV-infected patient with acute myeloid leukaemia

Bone Marrow Transplant. 2018 Dec;53(12):1518-1521. doi: 10.1038/s41409-018-0297-z. Epub 2018 Aug 16.

Abstract

Allogeneic stem cell transplantation (Allo-HSCT) is sine qua non to cure high-risk acute myeloid leukaemia (AML). In spite the advent of highly active antiretroviral treatment, HIV-infected patients display a remarkable risk for haematological neoplasms such as non-Hodgkin lymphomas, Hodgkin lymphoma and acute leukaemia. Several case series have confirmed the efficacy of the autologous stem cell transplantation for the treatment of non-Hodgkin lymphomas in the HIV setting. Nonetheless, there is a paucity of data for the role of the Allo-HSCT in HIV-infected individuals with haematological malignancies. Herein, we presented the successful long-term outcome of a HIV-infected patient who received reduced intensity conditioned, matched unrelated donor transplant with alemtuzumab as graft-versus-host disease prophylaxis for therapy-related acute myeloid leukaemia. We propose that Allo-HSCT in HIV patients is safe and that alemtuzumab-based conditioning could further work to eradicate HIV in those whose donor is not CCR5 homozygous.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Alemtuzumab / pharmacology
  • Alemtuzumab / therapeutic use*
  • Antineoplastic Combined Chemotherapy Protocols / pharmacology
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Graft vs Leukemia Effect / drug effects*
  • Hematopoietic Stem Cell Transplantation / adverse effects*
  • Hematopoietic Stem Cell Transplantation / methods
  • Humans
  • Leukemia, Myeloid, Acute / complications
  • Leukemia, Myeloid, Acute / drug therapy*
  • Leukemia, Myeloid, Acute / pathology
  • Male
  • Melphalan / pharmacology
  • Melphalan / therapeutic use*
  • Transplantation Conditioning / adverse effects*
  • Transplantation Conditioning / methods
  • Vidarabine / analogs & derivatives*
  • Vidarabine / pharmacology
  • Vidarabine / therapeutic use

Substances

  • Alemtuzumab
  • Vidarabine
  • fludarabine
  • Melphalan