Contributions
Abstract: PB2450
Type: Publication Only
Background
Human immunodeficiency virus (HIV) infection is associated with an increased incidence of non-Hodgkin lymphoma (NHL) and Hodgkin lymphoma (HL). Throughout the HAART era, autologous stem cell transplantation (ASCT) has been reported as a feasible approach to either rescue or consolidate HIV-related lymphoma patients. However, the number of published comparative studies according to the HIV status is limited.
Aims
An observational prospective study was designed to assess the safety and tolerability of intensive chemotherapy and ASCT for the treatment of HIV-related NHL and HL.
Methods
Since the Jan 2016 nine patients with HIV-related lymphoma who have undergone ASCT were included in prospective singe centre study (study group - HIV group, n=9). The data of the non-HIV-infected patients with lymphoma who have undergone ASCT at the same period of time (control group, n=36) were collected to compare the efficacy and safety of the procedure (1:4). Median follow up time was 12 (2-20) months. The primary end points were overall survival (OS) and relapse rate at 12 months after ASCT. Secondary end points were time to hematopoietic recovery and organ toxicity. Common Terminology Criteria for Adverse Events (CTCAE 4.0) for the toxicity analyse have been used. The underlying diseases in HIV-group were HL n=6 (67%) and NHL n=3 (33%). Conditioning regimen was BEAM with BCNU replacement by Bendamustine 160 mg/m2/day at D-7, D-6. HIV viral load was undetectable (100%); the median number of CD4+ cells was 265 cells/mcl; all patients were on HAART. An assessment of potential differences in patients, disease and treatment characteristics between the 2 groups showed no significant differences.
Results
Overall survival (OS) at 12 months for all patients (n=45) was 93,3%. OS at 12 months was 88,9% in HIV-group vs 94,4% (p=0,3) in control group. One patient died later on engraftment in HIV group (cerebral hemorrhage) and two in control group within 1.5 years after ASCT (lymphoma progression). Relapse rate of the underlying disease at 12 months was 14% in HIV-group, in control group – 11% (p=0,8). The median time of leukocytes, neutrophils, and platelets recovery was D+13, D+15, D+15 respectively in HIV-group and D+13, D+16, D+14 in control group. There were no differences in rate of organ (Nephrotoxicity, Hepatotoxicity, Enteropathy and Mucositis) toxicity according to CTCAE.
Conclusion
One-year overall survival in patients with HIV-related lymphoma was 88,9%, relapse rate – 14% and did not differ from the control group. There were no found significant differences between two groups in hematopoietic recovery and toxicity rate. Preliminary data provide further evidence that HIV status does not affect the outcome of ASCT for lymphoma. Patients with HIV-related lymphoma should be considered candidates for ASCT if they meet standard transplant criteria.
Session topic: 23. Stem cell transplantation - Clinical
Keyword(s): Autologous hematopoietic stem cell transplantation, HIV related lymphoma
Abstract: PB2450
Type: Publication Only
Background
Human immunodeficiency virus (HIV) infection is associated with an increased incidence of non-Hodgkin lymphoma (NHL) and Hodgkin lymphoma (HL). Throughout the HAART era, autologous stem cell transplantation (ASCT) has been reported as a feasible approach to either rescue or consolidate HIV-related lymphoma patients. However, the number of published comparative studies according to the HIV status is limited.
Aims
An observational prospective study was designed to assess the safety and tolerability of intensive chemotherapy and ASCT for the treatment of HIV-related NHL and HL.
Methods
Since the Jan 2016 nine patients with HIV-related lymphoma who have undergone ASCT were included in prospective singe centre study (study group - HIV group, n=9). The data of the non-HIV-infected patients with lymphoma who have undergone ASCT at the same period of time (control group, n=36) were collected to compare the efficacy and safety of the procedure (1:4). Median follow up time was 12 (2-20) months. The primary end points were overall survival (OS) and relapse rate at 12 months after ASCT. Secondary end points were time to hematopoietic recovery and organ toxicity. Common Terminology Criteria for Adverse Events (CTCAE 4.0) for the toxicity analyse have been used. The underlying diseases in HIV-group were HL n=6 (67%) and NHL n=3 (33%). Conditioning regimen was BEAM with BCNU replacement by Bendamustine 160 mg/m2/day at D-7, D-6. HIV viral load was undetectable (100%); the median number of CD4+ cells was 265 cells/mcl; all patients were on HAART. An assessment of potential differences in patients, disease and treatment characteristics between the 2 groups showed no significant differences.
Results
Overall survival (OS) at 12 months for all patients (n=45) was 93,3%. OS at 12 months was 88,9% in HIV-group vs 94,4% (p=0,3) in control group. One patient died later on engraftment in HIV group (cerebral hemorrhage) and two in control group within 1.5 years after ASCT (lymphoma progression). Relapse rate of the underlying disease at 12 months was 14% in HIV-group, in control group – 11% (p=0,8). The median time of leukocytes, neutrophils, and platelets recovery was D+13, D+15, D+15 respectively in HIV-group and D+13, D+16, D+14 in control group. There were no differences in rate of organ (Nephrotoxicity, Hepatotoxicity, Enteropathy and Mucositis) toxicity according to CTCAE.
Conclusion
One-year overall survival in patients with HIV-related lymphoma was 88,9%, relapse rate – 14% and did not differ from the control group. There were no found significant differences between two groups in hematopoietic recovery and toxicity rate. Preliminary data provide further evidence that HIV status does not affect the outcome of ASCT for lymphoma. Patients with HIV-related lymphoma should be considered candidates for ASCT if they meet standard transplant criteria.
Session topic: 23. Stem cell transplantation - Clinical
Keyword(s): Autologous hematopoietic stem cell transplantation, HIV related lymphoma