Jana K. Dickter, MD, associate clinical professor, Division of Infectious Diseases, City of Hope, discusses a patient's experience being the oldest person to successfully undergo a stem cell transplant while living with HIV and leukemia.
Depending on finding the right donor, stem cell transplantation may be a viable treatment option for people living with both HIV and leukemia, said Jana K. Dickter, MD, associate clinical professor, Division of Infectious Diseases, City of Hope.
How are stem cell transplants being used to treat patients with HIV and transform the health care landscape?
Stem cell transplantation is a complex procedure with significant side effects, so it isn't a suitable treatment option for the majority of people living with HIV. However, as people living with HIV age, some of them may eventually develop a blood cancer.
The City of Hope patient who had been living with HIV for many years developed leukemia, and we treated him with a particular type of stem cell transplant, and were able to get him into remission from both his leukemia and his HIV. And it's interesting how this was possible: The donor for the transplant for this patient carried a rare genetic mutation that makes people resistant to becoming infected with most strains of HIV. And this patient's experience is unique from the previous patients who were treated with stem cell transplantation for their respective blood cancers and then achieved remission from HIV.
At the age of 63, he was the oldest person to successfully undergo a stem cell transplant with HIV and leukemia and then achieve remission from both conditions, he had been living with HIV the longest of any of the patients to date for more than 31 years prior to his transplant, and he also received the least immunosuppressive preoperative regimen prior to his transplant compared to the other patients. This is the treatment that prepares the patient's immune system to receive the donor stem cells and their immune system. So the findings from this case mean that there can be a viable treatment for people with both HIV and leukemia who undergo stem cell transplantation, even for people who are older. That does depend, however, on finding the right stem cell donor.