HIV/AIDS Practice-Changing Study In Hiv-Related Lymphoma
SAN FRANCISCO ? Patients with HIV-related lymphoma should now be considered candidates for stem cell transplantation if need be, and the treatment does not need to be limited to certain centers, according experts commenting on the results of a new study. Autologous hematopoietic stem cell transplantation (AHCT) has been offered to patients with relapsed or treatment-resistant HIV-related lymphoma since the late 1990s, observed lead study author Joseph Alvarnas, MD, of City of Hope Medical Center, in Monrovia, California. But transplantation has been limited to centers with HIV-specific expertise, Dr Alvarnas explained to reporters at a press conference here at the American Society of Hematology (ASH) 56th Annual Meeting. Dr Joseph Alvarnas In addition, most clinical trials of AHCT have excluded patients with HIV, he added. In an effort to open up these two closed worlds, a clinical trial of AHCT was undertaken in patients with HIV-related lymphoma that had relapsed or was refractory. Among 40 patients who participated, the overall 1-year survival rate was 86.6%, and the progression-free survival rate was 82.3%, both of which compared well with 151 matched control patients with lymphoma who did not have HIV. In fact, there was no statistically significant difference between the HIV-related lymphoma patients and the control patients for rates of survival, treatment failure, disease progression, and treatment-related mortality. Dr Alvarnas summarized that patients with HIV-related lymphoma that is responsive to antiviral treatment "should be considered candidates for autologous HCT if they meet standard transplant criteria." The implication was that these patients can be treated in a much wider range of facilities and not just centers with HIV specialization.