156 Combination Antiretroviral Therapy during Autologous Stem Cell Transplant for HIV Infected Patients with Haematological Malignancies

Track: Poster Abstracts
Wednesday, February 11, 2015, 6:45 PM-7:45 PM
Grand Hall CD (Manchester Grand Hyatt)
Karim Ibrahim, BPharm, DClinPharm , Pharmacy, St. Vincent's Health Network, Darlinghurst NSW, Australia
Samuel Milliken, MD , Department of Hematology, St. Vincent's Hospital, Darlinghurst NSW, Australia
Presentation recording not available for download or distribution as requested by the presenting author.
In the post combination antiretroviral therapy (cART) era, HIV infected patients are better able to tolerate chemotherapy for HIV-associated lymphoma and results of the treatment are similar now to non-HIV infected patients. Consequently the use of hematopoietic stem cell transplant (HSCT) has been investigated in the post cART era. One of the main challenges that face clinicians though is the potential for cART and chemotherapy drug-drug interactions.

The aim of our study was to review toxicities related to the continuation of cART during chemotherapy in HIV-infected patients undergoing autologous stem cell transplants (ASCT) for haematological malignancies.

This was a retrospective study, which included HIV-infected patients who were on cART and underwent ASCT for a haematological malignancy from January 1st 2003 to December 31st2013 at a single institution. We reviewed adverse effects related to the use cART during conditioning chemotherapy.

A total of 11 patients were included, n=1 acute myeloid leukaemia (AML), n=4 multiple myeloma (MM), n=4 Burkitt lymphoma , n=1 plasmablastic lymphoma, n=1 primary effusion lymphoma and n=1 Hodgkin lymphoma. Of the 11 patients, 6 (54%) were on non-Protease inhibitor (PI) and 5 (56%) were on PI based cART during their transplant. No TRM were observed, all patients continued cART during conditioning chemotherapy. 6 Patients relapsed, 2 were salvaged by allogeneic HSCT, 2 MM patients were given salvage treatment. There were 5 non-treatment related deaths, n=1 developed secondary malignancy, n=1 relapsed AML, n=2 relapsed MM and one patient died due to zidovudine induced lactic acidosis 10 months post ASCT. Overall survival from ranged from 1-8 yrs.

This case series demonstrated that concomitant use of cART during conditioning chemotherapy for patients undergoing ASCT does not adversely affect treatment outcomes. Therefore, we recommend continuing cART during ASCT. However, we recommend avoiding zidovudine during conditioning chemotherapy due to high risk of myelosuppression.

Disclosures:
Nothing To Disclose
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