Allogeneic haematopoietic stem cell transplantation in patients with human immunodeficiency virus: the experiences of more than 25 years

Abstract

For treatment of several malignancies, transplantation of allogeneic haematopoietic stem cells (HSCT) derived from bone marrow or peripheral blood has been used as a therapeutic procedure for decades. In the past, HSCT has been suggested as a treatment option for infection with the human immunodeficiency virus type 1 (HIV-1), but these attempts were mostly unsuccessful. Today, after the introduction of an active anti-retroviral therapy, the lifetime expectancy of HIV-infected patients has improved substantially, but nevertheless the incidence rate of malignancies in these patients has increased considerably. Therefore, it can be assumed that there will be a rising necessity for HIV-1-infected patients with malignancies for allogeneic HSCT. At the same time, there is increasing interest in treatment methods which might target the HIV-1 reservoir more effectively, and the question has been raised as to whether allogeneic HSCT could be linked to such strategies. In this paper the data of more than 25 years experience with allogeneic HSCT in patients with HIV-1 are reviewed and analysed.

Fig. 1

T cell recovery after allogeneic haematopoietic stem cell transplantation in patents with human immunodeficiency virus (HIV) infection ongoing highly active anti-retroviral therapy (HAART) (n = 28). The dashed line displays the median values of CD4⁺ T cell counts.

Fig. 2

Kaplan–Meier estimation of the survival of human immunodeficiency virus (HIV)-infected patients after allogeneic haematopoietic stem cell transplantation reported from 1983 to 2010.