AUTOLOGOUS PERIPHERAL BLOOD STEM CELL TRANSPLANTATION IN PATIENTS WITH HIV-ASSOCIATED LYMPHOPROLYPHERATIVE DISORDER

Objective

Autologous transplantation of bone marrow/peripheral blood stem cells in patients with HIV-associated lymphopoliferative disorder is a feasible and relatively safe therapeutic option. However, at the moment there are a number of unsolved problems, including optimal risk/benefit pre-transplant conditioning, taking into account drug-drug interactions and indications for hematopoietic stem cell transplantation.

Methodology

Since 2020 PBSCT has been performed in 15 patients with HIV in our center. The 12 (80%), had diagnosis of HIV-associated plasmablastic lymphoma (HIV-PBL), 3 patients (20%) were with HIV-associated Hodgkin' lymphoma (HIV-HL). All of the patients with HIV-PBL were transplanted after completion of a first-line treatment and achievement of at least a partial response. The pre-transplant conditioning was performed using BEAM-like regimens.

Results

Toxicity from organs and systems did not exceed grade 2 (moderate) mainly from the gastrointestinal tract, no need antiretroviral therapy in all of the cases. Median time to neutrophil engraftment was +12 days, while to platelet engraftment was +13 days. At the time of submitting the abstract all of the transplanted patients described above except one (lethal case due to progression of concomitants hepatitis C virus (HCV) infection) are in the state of remission.

Conclusion

Autologous transplantation of peripheral blood stem cells in patients with HIV is a feasible and relatively safe option with clear planning of the patient's treatment strategy from the first day of therapy and accompanying consideration of drug-drug interactions which is confirmed both by world literature and our Center's own experience.