BMT CTN 0803/AMC 071: autologous haematopoietic cell transplantation for HIV-related lymphoma
People with HIV whose lymphoma had relapsed did as well after high-dose chemotherapy and a stem cell transplant as matched HIV-negative patients, with 87 percent alive at one year.
Overview
Single-arm phase 2 trial of the Blood and Marrow Transplant Clinical Trials Network and AIDS Malignancy Consortium: 43 HIV-infected patients with chemotherapy-sensitive relapsed or persistent aggressive B-cell or Hodgkin lymphoma were enrolled and 40 underwent autologous transplant after BEAM conditioning with consistent peri-transplant antiretroviral management.
At a median follow-up of 24.8 months one- and two-year overall survival were 87.3 and 82 percent, two-year progression-free survival 79.8 percent and one-year transplant-related mortality 5.2 percent; neutrophil and platelet recovery took 11 and 18 days; outcomes did not differ from 151 matched registry controls.
- One-year overall survival 87.3 percent (95% CI 72.1 to 94.5) and two-year 82 percent (65.9 to 91).
- Two-year progression-free survival 79.8 percent; one-year transplant-related mortality 5.2 percent.
- No significant difference from 151 matched HIV-negative controls.
HIV infection is not a reason to withhold autologous transplant from patients with relapsed lymphoma who meet standard transplant criteria.
- Small single-arm study in patients with controlled HIV and chemotherapy-sensitive disease.