Allogeneic Hematopoietic Cell Transplantation in Human Immunodeficiency Virus-Positive Patients with Hematologic Disorders: A Report from the Center for International Blood and Marrow Transplant Research

Vikas Gupta, Marcie Tomblyn, Tanya L. Pedersen, Harry L. Atkins, Minoo Battiwalla, Ronald E. Gress, Marilyn S. Pollack, Jan Storek, Jill C. Thompson, Pierre Tiberghien, Jo Anne H Young, Patricia Ribaud, Mary M. Horowitz, Armand Keating

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43 Scopus citations

Abstract

The role of allogeneic hematopoietic cell transplantation (alloHCT) in human immunodeficiency virus (HIV)-positive patients is not known. Using the Center for International Blood and Marrow Transplant Research database, we retrospectively evaluated 23 HIV-positive patients undergoing matched sibling donor (n = 19) or unrelated donor (n = 4) alloHCT between 1987 and 2003. The median age at alloHCT was 32 years. Indications for alloHCT were diverse and included malignant (n = 21) and nonmalignant (n = 2) hematologic disorders. Nine patients (39%) underwent transplantation after 1996, the approximate year that highly active antiretroviral therapy became standard treatment. The median time to neutrophil engraftment was 16 days (range, 7 to 30 days), and the cumulative incidences of grade II-IV acute graft-versus-host disease (aGVHD) at 100 days, chronic GVHD (cGVHD), and survival at 2 years were 30% (95% confidence interval [CI] = 14% to 50%), 28% (95% CI = 12% to 48%), and 30% (95% CI = 14% to 50%), respectively. At a median follow-up of 59 months, 6 patients were alive. Survival appears to be better in the patients undergoing alloHCT after 1996; 4 of these 9 patients survived, compared with only 2 of 14 those undergoing transplantation before 1996. These data suggest that alloHCT is feasible for selected HIV-positive patients with malignant and nonmalignant disorders. Prospective studies are needed to evaluate the safety and efficacy of this modality in specific diseases in these patients.

Original languageEnglish (US)
Pages (from-to)864-871
Number of pages8
JournalBiology of Blood and Marrow Transplantation
Volume15
Issue number7
DOIs
StatePublished - Jul 1 2009

Keywords

  • Allogeneic
  • Bone marrow transplantation
  • Human immunodeficiency virus
  • Malignancy

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    Gupta, V., Tomblyn, M., Pedersen, T. L., Atkins, H. L., Battiwalla, M., Gress, R. E., Pollack, M. S., Storek, J., Thompson, J. C., Tiberghien, P., Young, J. A. H., Ribaud, P., Horowitz, M. M., & Keating, A. (2009). Allogeneic Hematopoietic Cell Transplantation in Human Immunodeficiency Virus-Positive Patients with Hematologic Disorders: A Report from the Center for International Blood and Marrow Transplant Research. Biology of Blood and Marrow Transplantation, 15(7), 864-871. https://doi.org/10.1016/j.bbmt.2009.03.023