Allogeneic HCT safe for patients with HIV

A phase II multi-center study of 17 patients with HIV has shown that hematopoietic cell transplantation (HCT) can be a safe and effective treatment for HIV-positive patients, with a one-year overall survival of 59% and no 100-day non-relapse mortality.

Indications for HCT for the 17 patients were acute leukemia, myelodysplasia, or lymphoma and recipients had 8/8 HLA-matched related or at least 7/8 HLA-matched unrelated donors. Cumulative incidence of grade II-IV acute graft-versus-host disease (GVHD) was 41% at day 100; at one year, 17.6% experienced chronic GVHD.

Study results also showed that patients had reconstituted immunoglobulin levels and CD4+ T-cell counts post-transplant, which suggested that HCT was not associated with a long-term deterioration in cellular immunity. 

In patients who achieved complete chimerism, cell-associated HIV DNA and inducible infectious virus in the blood were not detectable.

The researchers concluded that HIV should not be viewed as a contraindication to transplant in patients with hematological malignancies who are otherwise eligible for transplant. In addition, they noted that patients with HIV infection should be considered appropriate for participation in clinical trials aimed at reducing relapse or progression of malignant disease and other approaches to improve overall outcomes.

This study was conducted by the Blood and Marrow Transplant Clinical Trials Network (BMT CTN) — 0903 and the AIDS Malignancy Consortium — 080.

Ambinder RF, et al., Biol Blood Marrow Transplant