TY - JOUR
T1 - Autologous hematopoietic cell transplantation for HIV-related lymphoma
T2 - Results of the BMT CTN 0803/AMC 071 trial
AU - Alvarnas, Joseph C.
AU - Le Rademacher, Jennifer
AU - Wang, Yanli
AU - Little, Richard F.
AU - Akpek, Gorgun
AU - Ayala, Ernesto
AU - Devine, Steven
AU - Baiocchi, Robert
AU - Lozanski, Gerard
AU - Kaplan, Lawrence
AU - Noy, Ariela
AU - Popat, Uday
AU - Hsu, Jack
AU - Morris, Lawrence E.
AU - Thompson, Jason
AU - Horowitz, Mary M.
AU - Mendizabal, Adam
AU - Levine, Alexandra
AU - Krishnan, Amrita
AU - Forman, Stephen J.
AU - Navarro, Willis H.
AU - Ambinder, Richard
N1 - Publisher Copyright:
Copyright 2011 by The American Society of Hematology; all rights reserved.
PY - 2016/8/25
Y1 - 2016/8/25
N2 - 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 atleast 1 infectious episode posttransplant. At 1 year post-AHCT, median CD4+T-cellcount 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.
AB - 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 atleast 1 infectious episode posttransplant. At 1 year post-AHCT, median CD4+T-cellcount 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.
KW - Autologous hematopoietic cell transplantation is safe and effective in patients with HIV-related lymphoma who meet standard transplant criteria.
KW - Patients with HIV-related lymphomas should not be precluded from participating in AHCT clinical trials
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U2 - 10.1182/blood-2015-08-664706
DO - 10.1182/blood-2015-08-664706
M3 - Article
C2 - 27297790
AN - SCOPUS:84984815928
SN - 0006-4971
VL - 128
SP - 1050
EP - 1058
JO - Blood
JF - Blood
IS - 8
ER -