Autologous stem cell transplantation for HIV-associated lymphoma in the antiretroviral and rituximab era: a retrospective study by the EBMT Lymphoma Working Party

• Published in: Bone marrow transplantation (Basingstoke) Vol. 54; no. 10; pp. 1625 - 1631
• Main Authors: Hübel, Kai, Re, Alessandro, Boumendil, Ariane, Finel, Herve, Hentrich, Marcus, Robinson, Stephen, Wyen, Christoph, Michieli, Mariagrazia, Kanfer, Edward, Diez-Martin, Jose Luis, Balsalobre, Pascual, Vincent, Laure, Schroyens, Wilfried, Santasusana, Josep Maria Ribera, Kröger, Nicolaus, Schiel, Xaver, Cwynarski, Kate, Esquirol, Albert, Sousa, Aida Botelho, Cattaneo, Chiara, Montoto, Silvia, Dreger, Peter
• Format: Journal Article
• Language: English
• Published: England Nature Publishing Group 01.10.2019
• Subjects: Antimitotic agents; Antineoplastic agents; Antiretroviral agents; Antiretroviral drugs; Antiretroviral therapy; Autografts; B-cell lymphoma; Bone marrow; Burkitt's lymphoma; Care and treatment; CD4 antigen; Hematopoietic stem cells; HIV; HIV patients; Hodgkin's lymphoma; Human immunodeficiency virus; Immunotherapy; Lymphocytes B; Lymphoma; Lymphomas; Monoclonal antibodies; Multivariate analysis; Remission; Risk analysis; Risk factors; Rituximab; Stem cell transplantation; Stem cells; Survival; Targeted cancer therapy; Transplantation; Germany
• ISSN: 0268-3369; 1476-5365
• DOI: 10.1038/s41409-019-0480-x

The present study aimed at describing the outcome of patients with HIV-associated lymphomas following autologous hematopoietic stem cell transplantation (autoHCT) in the rituximab and combined antiretroviral therapy (cART) era. Eligible for this retrospective study were HIV-positive patients with lymphoma who received autoHCT between 2007 and 2013. A total of 118 patients were included with a median age of 45 years (range 24-66). Underlying diagnoses were diffuse large B cell lymphoma in 47%, Hodgkin lymphoma in 24%, Burkitt lymphoma in 18%, and plasmablastic lymphoma in 7% of patients. Disease status at autoHCT was complete remission in 44%, partial remission (PR) in 38%, and less than PR in 18% of the patients. With a median follow-up of 4 years, 3-year non-relapse mortality, incidence of relapse, progression-free survival (PFS) and overall survival (OS) were 10%, 27%, 63% and 66%, respectively. By multivariate analysis, disease status less than PR but not CD4+ cell count at the time of autoHCT was a significant predictor of unfavorable PFS and OS. In conclusion, in the era of cART and chemoimmunotherapy, the outcome of autoHCT for HIV-related lymphoma is driven by lymphoma-dependent risk factors rather than by characteristics of the HIV infection.