HIV-1 Infection Shouldn’t Preclude HCT for Lymphoma

One-year overall survival is 86.6% in patients with HIV-associated lymphoma treated with autologous hematopoietic cell transplantation (HCT), according to results from a study conducted by the Blood and Marrow Transplant Clinical Trials Network (BMT CTN) and presented at ASH. Patients older than 15 years with treatable human immunodeficiency virus (HIV)-1 infection, adequate organ function, and chemotherapy-sensitive, relapsed/refractory aggressive non-Hodgkin or Hodgkin lymphoma were eligible for the study. Outcomes of 40 patients undergoing autologous HCT between 2010 and 2013 were analyzed.

Median age was 46.9 years (range, 22.5-62.2), and standard BEAM conditioning was used in all patients. Prior to transplant, 30 patients (75%) were in complete remission (CR), 8 (20%) were in partial remission (PR), and 2 (5%) had relapsed/progressive disease. Pre-transplant HIV viral load was undetectable in 31 patients (77.5%) and detectable in 9 (22.5%). Overall survival, progression-free survival, transplant-related mortality, and relapse/progression were 86.6%, 82.3%, 5.2%, and 12.5%, respectively.

Lead researcher Dr. Joseph Alvarnas, of the City of Hope National Medical Center, Duarte, California, concluded that “patients with HIV-associated lymphoma may successfully undergo autologous HCT with favorable outcomes.” He further noted that autologous HCT should be considered the standard of care for patients with relapsed/refractory HIV-associated lymphoma who meet standard eligibility criteria.

Alvarnas J, et al. Blood