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Outcomes of autologous stem cell transplantation (ASCT) in patients with relapsed/refractory HIV-associated lymphoma

Bone Marrow Transplantation volume 51, pages 1609–1611 (2016)Cite this article

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HIV increases the risk of cancer,1 and the incidence of lymphoma among people living with HIV (PLWH) is higher than in the general population.2 Before the availability of combined antiretroviral therapy (cART), HIV-associated lymphoma (HIV+Ly) was associated with a poor prognosis as treatment options were limited due to the toxicity of chemotherapy and the significant risk of opportunistic infections. The introduction of cART in 1996, along with better management of opportunistic infections, and the use of CSFs to support higher-dose intensity combination chemotherapy, has led to improved survival among patients with HIV+Ly.3 The survival rates for HIV+Ly among PLWH are comparable to HIV-negative patients treated for Hodgkin lymphoma, Burkitt lymphoma and diffuse large B-cell lymphoma.4, 5 However, as in the general population, there is a proportion of lymphomas that do not respond or relapse following first-line chemotherapy. High-dose chemotherapy with autologous stem cell transplantation (ASCT) has been the standard approach for refractory and relapsed lymphoma since the late 1990s based on phase III clinical trials.6, 7

The information regarding salvage options for patients with refractory or relapsed HIV-associated lymphoma (r-HIV+Ly) comes from retrospective studies.8, 9 In general, salvage chemotherapy regimens used as second-line treatment of r-HIV+Ly prior to ASCT are individualised and are based on trials in the HIV-negative population, where no regimen has been shown to be superior to others, but platinum-based combination chemotherapy, such as DHAP (dexamethasone, cytarabine and cisplatin), is generally used.

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Authors and Affiliations

  1. National Centre for HIV Malignancies, Chelsea & Westminster Hospital, London, UK

    R Ramaswami, A Dalla Pria, K Parker, S McCann, M Nelson & M Bower

  2. Department of Haematology, Hammersmith Hospital, London, UK

    E J Kanfer

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  1. R Ramaswami
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  2. A Dalla Pria
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  3. K Parker
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  4. S McCann
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  6. M Nelson
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  7. M Bower
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Correspondence to M Bower.

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Ramaswami, R., Pria, A., Parker, K. et al. Outcomes of autologous stem cell transplantation (ASCT) in patients with relapsed/refractory HIV-associated lymphoma. Bone Marrow Transplant 51, 1609–1611 (2016). https://doi.org/10.1038/bmt.2016.219

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