ALLOGENEIC BONE-MARROW TRANSPLANTATION COMBINED WITH MULTIPLE ANTI-HIV-1 TREATMENT IN A CASE OF AIDS

A 25-year-old woman with AIDS was submitted to HLA-identical allogenei c BMT after cytoablation with busulphan and cyclophosphamide and combi ned anti-HIV-l therapy with zidovudine, IFN-alpha 2 and anti-HIV-1-spe cific T cell clones. Marrow engraftment occurred after 18 days and tes ts for HIV-1 were negative after 30 days but the hematologic reconstit ution of the patient was poor. A second BM infusion from the same dono r was ineffective and treatment with GM-CSF only induced a transient i ncrease of the blood cell count, suggesting iatrogenic damage to the B M microenvironment. The development of ARDS led to the death of the pa tient 10 months after transplantation. Post-mortem investigation did n ot reveal any active infections and PCR on autopsy tissues was negativ e for HIV-1.