The advent of highly active antiretroviral therapy (HAART) and its co-administration with chemotherapy in patients with human immunodeficiency virus (HIV)-related lymphoma has lead to the exploration of potentially curative combination chemotherapy and myeloablative therapy followed by autologous haematopoietic stem cell transplantation (ASCT). Applying the same principles used for patients with HIV-negative aggressive lymphoma, in 1998 we developed a program of high-dose therapy and ASCT at City of Hope for patients with HIV-related lymphoma and Hodgkin's disease. Our studies have primarily included patients with chemosensitive lymphoma in relapse or first remission with poor-risk features at diagnosis. Filgrastim (G-CSF)-primed peripheral blood stem cell mobilization and apheresis have been successful while patients were receiving HAART and chemotherapy. To date, ASCT has been performed in 19 patients with HIV-related lymphoid malignancies, representing the largest single-institution experience reported to date. Most patients received a chemotherapy-based conditioning regimen consisting of high-dose carmustine, etoposide and cyclophosphamide. Early infections, namely bacteremias and neutropenic fever were similar to those observed in the HIV-negative transplant setting. Opportunistic infections were rare and easily treatable. There were three early deaths, two from relapsed lymphoma and one from multi-organ failure in an older patient. The remaining 16 patients are alive and in remission. In summary, ASCT is well tolerated, can result in long-term remissions, and is potentially curative in selected HIV-related lymphoma patients with chemosensitive relapse and high-risk disease in first remission defined by the age-adjusted International Prognostic Index criteria (i.e., two or three of the following: elevated LDH, advanced stage, and poor performance status). Acquisition of resistance to HAART remains as a potential problem for HIV-positive patients who are cured of their lymphoma.

中文翻译：

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造血干细胞移植治疗人类免疫缺陷病毒相关淋巴瘤。

高活性抗逆转录病毒疗法（HAART）的出现及其在与人类免疫缺陷病毒（HIV）相关的淋巴瘤患者的化疗中的联合使用已导致探索潜在的治愈性联合化疗和清髓疗法联合自体造血干细胞移植（ ASCT）。应用与HIV阴性侵袭性淋巴瘤患者相同的原理，1998年，我们在希望之城制定了针对HIV相关淋巴瘤和霍奇金病患者的大剂量治疗和ASCT计划。我们的研究主要包括化学敏感性淋巴瘤复发或首次缓解且诊断时风险低的患者。在接受HAART和化疗的患者中，以Filgrastim（G-CSF）引发的外周血干细胞动员和单采已经成功。迄今为止，已经对19例HIV相关淋巴恶性肿瘤患者进行了ASCT，这是迄今为止报道的最大的单机构经验。大多数患者接受了基于化学疗法的调理方案，包括大剂量卡莫司汀，依托泊苷和环磷酰胺。早期感染，即菌血症和中性粒细胞减少，与在HIV阴性移植环境中观察到的相似。机会感染很少见，很容易治愈。一例老年患者有3例早期死亡，其中2例是复发性淋巴瘤死亡，另一例是多器官衰竭。其余16名患者仍在世，并且已经缓解。总而言之，ASCT的耐受性良好，可以导致长期缓解，并且在某些患者中具有化学敏感性复发和高危疾病的某些HIV相关淋巴瘤患者具有首次治愈的潜力，该患者是根据年龄调整的国际预后指数标准定义的（即，以下两项或三项：乳酸脱氢酶升高，进入晚期并表现不佳）。对于已经治愈其淋巴瘤的HIV阳性患者，获得对HAART的抗性仍然是潜在的问题。