Allogeneic hematopoietic cell transplantation in HIV-positive patients with hematological disorders: A report from the Center for International Blood and Marrow Transplant Research (CIBMTR)

摘要

The role of allogeneic hematopoietic cell transplantation (alloHCT) in HIV-positive patients is not known. Using the CIBMTR database, we retrospectively evaluated 23 HIV-positive patients undergoing matched sibling (n=19) or unrelated (n=4) donor transplants between 1987 and 2003. The median age at alloHCT was 32 years. Indications for alloHCT were diverse and included malignant (n=21) and non-malignant (n=2) hematologic disorders. Nine patients (39%) were transplanted after 1996, the approximate year highly active anti-retroviral therapy became standard. The median time to neutrophil engraftment was 16 days (range 7–30) and the cumulative incidences of grades II – IV acute graft-versus-host disease (GVHD) at 100 days, chronic GVHD and survival at 2 years were 30% (95% C.I. 14-50), 28% (95% C.I. 12-48) and 30% (95% C.I. 14-50), respectively. At a median follow-up of 59 months, 6 patients are alive. Survival appears better among the patients transplanted after 1996: 4 of 9 patients transplanted after 1996 survive compared to 2 of 14 patients transplanted prior to 1996. These data suggest that alloHCT is feasible for selected HIV-positive patients with malignant and non-malignant disorders. Prospective studies are needed in these patients to evaluate the safety and efficacy of this modality in specific diseases.