Autologous stem cell transplantation for HIV-associated lymphoma

Is peripheral stem cell mobilization followed by autologous stem cell trans plantation (ASCT) feasible in patients with human immunodeficiency virus (H IV)associated lymphoma (HIV-L)? Studies have demonstrated that, in the HIV- negative (HIV-) setting, ASCT may improve lymphoma-free survival in highris k non-Hodgkin lymphoma (NHL) or relapsed Hodgkin disease (HID) and NHL. Giv en the poor prognosis of HIV-L with conventional chemotherapy, this dose-in tensive approach was explored. Nine patients with HIV-HD or NHL mobilized a median of 10.6 X 10(6) CD34(+) cells/kg and engrafted after ASCT. CD4 coun ts recovered to pretransplantation levels and HIV viral loads were controll ed in patients compliant with antiretroviral therapy. Seven of 9 patients r emain in remission from their lymphoma at a median of 19 months after trans plantation. Thus, patients with HIV-L on antiretroviral therapy can engraft following ASCT. Prolonged lymphoma remissions, without significant comprom ise of immune function, can be seen, suggesting that ASCT can be used in se lected patients with HIV-L. (C) 2001 by The American Society of Hematology.