Autologous Hematopoietic Stem Cell Transplant Safe, Effective for HIV-Related Lymphoma
Data presented at the virtual ESMO Congress support the use of autologous stem cell transplantation (ASCT) in patients with HIV-related lymphoma.
“The number of prospective matched case-controlled studies to prove the safety and efficacy of [ASCT] in HIV-related lymphoma is limited,” wrote Marina O. Popova, MD, and co-investigators.
Between January 2016 and January 2020, a total of 12 patients with HIV-related lymphoma who underwent ASCT were included in the study, along with 48 patients without HIV who were enrolled to the control group (median age, 34 years).
Among the study participants, underlying diseases included Hodgkin lymphoma (HL) in 7 (58.3%) and non-Hodgkin lymphoma (NHL) in 5 (41.7%). Conditioning regimen comprised BEAM with BCNU replacement by bendamustine 160 mg/m2 daily.
“HIV viral load was undetectable; the median number of CD4+ cells was 471.5 (210-715) cells/mcL, and all patients were on anti-retroviral therapy,” the investigators said. Follow-up lasted for a median of 16 months.
Results showed that the 2-year overall survival rates between the 2 group were not significantly different (91.7% in the study group vs 89.9% in the control group; P = .763). The 2-year progression-free survival (PFS) rate was 75% versus 70,8%, respectively (P = .777).
Furthermore, the 2-year time-to-progression was 14.6% in the study group versus 16.7% in the control group (P = .643).
Of note, patients in the study group had significantly delayed neutrophil recovery (P = .04), and there were no differences reported in organ toxicity rate. The 2-year transplant-related mortality (TRM) was 8.3% and 6.2% in the study and control groups, respectively (P = .8).
“Two-year overall survival in patients with HIV-related lymphoma was 91.7%, PFS was 75%, TTP was 14,6% and TRM was 8,3% and did not differ significantly from the control group. Only neutrophil recovery was significantly delayed after ASCT in patients with HIV-related lymphoma,” Dr Popova and colleagues reported.
“Our data provide further evidence that ASCT is a safe and effective approach for patients with HIV-related lymphoma,” they concluded.—Hina M. Porcelli
Popova M, Tsygankov I, Rogacheva Y, et al. High-dose chemotherapy with autologous hematopoietic stem cell transplantation in patients with HIV-related lymphoma. Presented at: the ESMO Virtual Congress 2020; September 19-21, 2020; virtual. Abstract 892MO.
