TY - JOUR
T1 - Hematopoietic stem cell transplantation in HIV-1-infected individuals
T2 - Clinical challenges and the potential for viral eradication
AU - Durand, Christine M.
AU - Ambinder, Richard F.
PY - 2013/3
Y1 - 2013/3
N2 - Purpose of Review: We will review the evidence that hematopoietic stem cell transplantation is well tolerated and effective in HIV-1-infected individuals with high-risk hematologic malignancies. We will discuss the challenges of using blood and marrow transplant strategies in this population, as well as the potential impact that hematopoietic stem cell transplantation has on HIV-1 reservoirs and persistence. Recent Findings: Advances in stem cell transplantation and the success of antiretroviral therapy (ART) have made it possible to extend curative cancer therapy to HIV-1-infected individuals with aggressive lymphoma and leukemia. Outcomes of autologous hematopoietic stem cell transplantation in HIV-1-infected individuals are similar to the general population. In allogeneic hematopoietic stem cell transplantation (alloHSCT), there are a growing number of successful case reports and the first national trial is ongoing. Infectious complications do not appear to be increased in patients on effective ART; however, drug interactions and drug interruptions are common. There is also renewed interest in the possibility that alloHSCT could lead to HIV-1 cure. Summary: HIV-1 infection is not a contraindication to blood and marrow transplantation and may offer unique benefits. Particular attention to preventing infectious complications, drug interactions, and drug interruptions in this patient population is required.
AB - Purpose of Review: We will review the evidence that hematopoietic stem cell transplantation is well tolerated and effective in HIV-1-infected individuals with high-risk hematologic malignancies. We will discuss the challenges of using blood and marrow transplant strategies in this population, as well as the potential impact that hematopoietic stem cell transplantation has on HIV-1 reservoirs and persistence. Recent Findings: Advances in stem cell transplantation and the success of antiretroviral therapy (ART) have made it possible to extend curative cancer therapy to HIV-1-infected individuals with aggressive lymphoma and leukemia. Outcomes of autologous hematopoietic stem cell transplantation in HIV-1-infected individuals are similar to the general population. In allogeneic hematopoietic stem cell transplantation (alloHSCT), there are a growing number of successful case reports and the first national trial is ongoing. Infectious complications do not appear to be increased in patients on effective ART; however, drug interactions and drug interruptions are common. There is also renewed interest in the possibility that alloHSCT could lead to HIV-1 cure. Summary: HIV-1 infection is not a contraindication to blood and marrow transplantation and may offer unique benefits. Particular attention to preventing infectious complications, drug interactions, and drug interruptions in this patient population is required.
KW - AIDS lymphoma
KW - HIV-1 cure
KW - HIV-1 eradication
KW - allogeneic hematopoietic stem cell transplantation
KW - bone marrow transplantation
UR - http://www.scopus.com/inward/record.url?scp=84873617216&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84873617216&partnerID=8YFLogxK
U2 - 10.1097/CCO.0b013e32835d814a
DO - 10.1097/CCO.0b013e32835d814a
M3 - Review article
C2 - 23385862
AN - SCOPUS:84873617216
SN - 1040-8746
VL - 25
SP - 180
EP - 186
JO - Current opinion in oncology
JF - Current opinion in oncology
IS - 2
ER -