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
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...
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| Veröffentlicht in: | Biology of blood and marrow transplantation 2009-07, Vol.15 (7), p.864-871 |
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| creator | Gupta, Vikas Tomblyn, Marcie Pedersen, Tanya L Atkins, Harry L Battiwalla, Minoo Gress, Ronald E Pollack, Marilyn S Storek, Jan Thompson, Jill C Tiberghien, Pierre Young, Jo-Anne H Ribaud, Patricia Horowitz, Mary M Keating, Armand |
| description | 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. |
| doi_str_mv | 10.1016/j.bbmt.2009.03.023 |
| format | Article |
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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.</description><identifier>ISSN: 1083-8791</identifier><identifier>EISSN: 1523-6536</identifier><identifier>DOI: 10.1016/j.bbmt.2009.03.023</identifier><identifier>PMID: 19539219</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Acute Disease ; Adolescent ; Adult ; Allogeneic ; Antiretroviral Therapy, Highly Active ; Bone marrow transplantation ; Child ; Chronic Disease ; Disease-Free Survival ; Female ; Graft Survival ; Graft vs Host Disease ; Graft vs Host Disease - mortality ; Graft vs Host Disease - therapy ; Hematologic Diseases ; Hematologic Diseases - complications ; Hematologic Diseases - mortality ; Hematologic Diseases - therapy ; Hematology, Oncology and Palliative Medicine ; Hematopoietic Stem Cell Transplantation ; HIV Seropositivity ; HIV Seropositivity - complications ; HIV Seropositivity - mortality ; HIV Seropositivity - therapy ; Human immunodeficiency virus ; Humans ; Immunology ; Life Sciences ; Male ; Malignancy ; Retrospective Studies ; Survival Rate ; Time Factors ; Transplantation, Homologous</subject><ispartof>Biology of blood and marrow transplantation, 2009-07, Vol.15 (7), p.864-871</ispartof><rights>American Society for Blood and Marrow Transplantation</rights><rights>2009 American Society for Blood and Marrow Transplantation</rights><rights>Distributed under a Creative Commons Attribution 4.0 International License</rights><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c490t-c5d47f97951dd27218e0afa920010e9e80e883de59f31335ee9769187a2e376f3</citedby><cites>FETCH-LOGICAL-c490t-c5d47f97951dd27218e0afa920010e9e80e883de59f31335ee9769187a2e376f3</cites><orcidid>0000-0002-9310-8322</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.bbmt.2009.03.023$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>230,315,781,785,886,3551,27928,27929,45999</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19539219$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://inserm.hal.science/inserm-00484480$$DView record in HAL$$Hfree_for_read</backlink></links><search><creatorcontrib>Gupta, Vikas</creatorcontrib><creatorcontrib>Tomblyn, Marcie</creatorcontrib><creatorcontrib>Pedersen, Tanya L</creatorcontrib><creatorcontrib>Atkins, Harry L</creatorcontrib><creatorcontrib>Battiwalla, Minoo</creatorcontrib><creatorcontrib>Gress, Ronald E</creatorcontrib><creatorcontrib>Pollack, Marilyn S</creatorcontrib><creatorcontrib>Storek, Jan</creatorcontrib><creatorcontrib>Thompson, Jill C</creatorcontrib><creatorcontrib>Tiberghien, Pierre</creatorcontrib><creatorcontrib>Young, Jo-Anne H</creatorcontrib><creatorcontrib>Ribaud, Patricia</creatorcontrib><creatorcontrib>Horowitz, Mary M</creatorcontrib><creatorcontrib>Keating, Armand</creatorcontrib><title>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</title><title>Biology of blood and marrow transplantation</title><addtitle>Biol Blood Marrow Transplant</addtitle><description>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.</description><subject>Acute Disease</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Allogeneic</subject><subject>Antiretroviral Therapy, Highly Active</subject><subject>Bone marrow transplantation</subject><subject>Child</subject><subject>Chronic Disease</subject><subject>Disease-Free Survival</subject><subject>Female</subject><subject>Graft Survival</subject><subject>Graft vs Host Disease</subject><subject>Graft vs Host Disease - mortality</subject><subject>Graft vs Host Disease - therapy</subject><subject>Hematologic Diseases</subject><subject>Hematologic Diseases - complications</subject><subject>Hematologic Diseases - mortality</subject><subject>Hematologic Diseases - therapy</subject><subject>Hematology, Oncology and Palliative Medicine</subject><subject>Hematopoietic Stem Cell Transplantation</subject><subject>HIV Seropositivity</subject><subject>HIV Seropositivity - complications</subject><subject>HIV Seropositivity - mortality</subject><subject>HIV Seropositivity - therapy</subject><subject>Human immunodeficiency virus</subject><subject>Humans</subject><subject>Immunology</subject><subject>Life Sciences</subject><subject>Male</subject><subject>Malignancy</subject><subject>Retrospective Studies</subject><subject>Survival Rate</subject><subject>Time Factors</subject><subject>Transplantation, Homologous</subject><issn>1083-8791</issn><issn>1523-6536</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kk2OEzEUhFsIxAwDF2CBvGJFgt3uHxuhkUL4SaQgRjCwtTz2a-LgtoPtzig77sC5uAQnwT2JALFg5Wepqp5Vn4viIcFTgknzdDO9uurTtMSYTzGd4pLeKk5JXdJJU9Pmdp4xoxPWcnJS3ItxgzFuK8bvFieE15SXhJ8WP2bW-s_gwCi0gF4mv_UGUr7NwVp0GaSLWytdksl4h4xDi6GXDi37fnBeQ2eUAaf26JMJQ_z57fuFjyaZHaCL7ACXIro2aX3Mzqty8ksTfdAQ4jM0Q-9h60NCXfA9SmvIa12CgDof0HKc3M1iadEL671G0mn0Vobgr_96Ww6JIINa3y_udNJGeHA8z4qPr19dzheT1bs3y_lsNVEVx2mial21HW95TbQu25IwwLKTPDdJMHBgGBijGmreUUJpDcDbhhPWyhJo23T0rHhyyF1LK7bB9DLshZdGLGYrYVyE0AuMK1ZVDO9Ilj8-yLfBfx0gJtGbqHK_0oEfomhaymvOqywsD0IVfIwBut_hBIuRudiIkbkYmQtMRWaeTY-O6cNVD_qP5Qg5C54fBJAr2RkIIt5AA20CqCS0N__PP__HrqxxRkn7BfYQN37IkGwURMRSYPFh_HXjp8M818kop78AmI3XgQ</recordid><startdate>20090701</startdate><enddate>20090701</enddate><creator>Gupta, Vikas</creator><creator>Tomblyn, Marcie</creator><creator>Pedersen, Tanya L</creator><creator>Atkins, Harry L</creator><creator>Battiwalla, Minoo</creator><creator>Gress, Ronald E</creator><creator>Pollack, Marilyn S</creator><creator>Storek, Jan</creator><creator>Thompson, Jill C</creator><creator>Tiberghien, Pierre</creator><creator>Young, Jo-Anne H</creator><creator>Ribaud, Patricia</creator><creator>Horowitz, Mary M</creator><creator>Keating, Armand</creator><general>Elsevier Inc</general><general>Elsevier</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>1XC</scope><orcidid>https://orcid.org/0000-0002-9310-8322</orcidid></search><sort><creationdate>20090701</creationdate><title>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</title><author>Gupta, Vikas ; 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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.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>19539219</pmid><doi>10.1016/j.bbmt.2009.03.023</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-9310-8322</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Biology of blood and marrow transplantation, 2009-07, Vol.15 (7), p.864-871 |
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| source | MEDLINE; Access via ScienceDirect (Elsevier); EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection |
| subjects | Acute Disease Adolescent Adult Allogeneic Antiretroviral Therapy, Highly Active Bone marrow transplantation Child Chronic Disease Disease-Free Survival Female Graft Survival Graft vs Host Disease Graft vs Host Disease - mortality Graft vs Host Disease - therapy Hematologic Diseases Hematologic Diseases - complications Hematologic Diseases - mortality Hematologic Diseases - therapy Hematology, Oncology and Palliative Medicine Hematopoietic Stem Cell Transplantation HIV Seropositivity HIV Seropositivity - complications HIV Seropositivity - mortality HIV Seropositivity - therapy Human immunodeficiency virus Humans Immunology Life Sciences Male Malignancy Retrospective Studies Survival Rate Time Factors Transplantation, Homologous |
| title | 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 |
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