Journal
BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION
Volume 14, Issue 1, Pages 59-66Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.bbmt.2007.03.014
Keywords
acquired immunodeficiency syndrome; autologous stem cell transplantation; busulfan; cyclophosphamide; lymphoma
Categories
Funding
- NCI NIH HHS [U01CA070019, R01 CA095423, U01 CA070062, U01CA083035, U01 CA121947, P50 CA096888, U01 CA070054, U01CA070054, U01CA070047, U01CA071375, U01CA083118, U01CA083216, U01 CA071375, U01 CA083118, U01 CA083035, U01 CA070019, U01 CA070047, U01CA070062] Funding Source: Medline
- NATIONAL CANCER INSTITUTE [U01CA083118, U01CA121947, U01CA083216, U01CA070062, U01CA071375, U01CA083035, U01CA070054, U01CA070047, U01CA070019, R01CA095423, P50CA096888] Funding Source: NIH RePORTER
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Intensive chemotherapy for human immunodeficiency virus (HIV)-associated non-Hodgkin lymphoma (NHL) and Hodgkin lymphoma (HL) has resulted in durable remissions in a substantial proportion of patients. High-dose chemotherapy and autologous stem cell transplantation (AuSCT), moreover, has resulted in sustained complete remissions in selected patients with recurrent chemosensitive disease. Based on a favorable experience with dose-reduced high-dose busulfan, cyclophosphamide, and AuSCT for older patients with non-HIV-associated aggressive lymphomas, an AIDS Malignancy Consortium multicenter trial was undertaken using the same dose-reduced busulfan and cyclophosphamide preparative regimen with AuSCT for recurrent HIV-associated NHL and HL. Of the 27 patients in the study, 20 received an AuSCT. The median time to achievement of an absolute neutrophil count (ANC) of >= 0.5 x 10(9)/L was 11 days (range, 9-16 days). The median time to achievement of an unsupported platelet count of 20 x 10(9)/L was 13 days (range, 6-57 days). One patient died on day +33 posttransplantation from hepatic veno-occlusive disease (VOD) and multiorgan failure. No other fatal regimen-related toxicity occurred. Ten of 19 patients (53%) were in complete remission at the time of their day + 100 post-AuSCT evaluation. Of the 20 patients, 10 were alive and event-free at a median of 23 weeks post-AuSCT. Median overall survival (OS) was not reached by 13 of the 20 patients alive at the time of last follow-up. This multi-institutional trial demonstrates that a regimen of dose-reduced high-dose busulfan, cyclophosphamide, and AuSCT is well tolerated and is associated with favorable disease-free survival (DFS) and OS probabilities for selected patients with HIV-associated NHL and HL. (c) 2008 American Society for Blood and Marrow Transplantation.
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