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Blood. 2016 Aug 25;128(8):1050-8. doi: 10.1182/blood-2015-08-664706. Epub 2016 Jun 13.

Autologous hematopoietic cell transplantation for HIV-related lymphoma: results of the BMT CTN 0803/AMC 071 trial.

Author information

1
Department of Hematology/Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA;
2
Center for International Blood & Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI;
3
The Emmes Corporation, Rockville, MD;
4
Cancer Therapy Evaluation Program, National Cancer Institute, Rockville, MD;
5
Greenebaum Cancer Center, University of Maryland Medical Systems, Baltimore, MD;
6
Department of Blood and Marrow Transplantation, H. Lee Moffitt Cancer Center, Tampa, FL;
7
Department of Hematology, The Ohio State University-Arthur G. James Cancer Center Hospital, Columbus, OH;
8
Division of Hematology/Oncology, University of California, San Francisco, CA;
9
Division of Hematological Oncology, Memorial Sloan Kettering Cancer Center, New York, NY;
10
Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, TX;
11
Bone Marrow Transplant Program, University of Florida Health Cancer Center, Gainesville, FL;
12
The Blood and Marrow Transplant Group of Georgia, Northside Hospital Cancer Institute, Atlanta, GA;
13
City of Hope National Medical Center, Duarte, CA;
14
National Marrow Donor Program, Minneapolis, MN; and.
15
Department of Oncology, Johns Hopkins School of Medicine, Baltimore, MD.

Abstract

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 at least 1 infectious episode posttransplant. At 1 year post-AHCT, median CD4(+) T-cell count 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. The trial was registered at www.clinicaltrials.gov as #NCT01141712.

PMID:
27297790
PMCID:
PMC5000843
DOI:
10.1182/blood-2015-08-664706
[Indexed for MEDLINE]
Free PMC Article

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