B-and T-lymphocyte number and function in HIV+/HIV- lymphoma patients treated with high-dose chemotherapy and autologous bone marrow transplantation

Combination of anti-retroviral therapy, high-dose chemotherapy (HCT) and autologous stem cell
transplantation (ASCT) has led to an improved survival of HIV+ non-Hodgkin lymphoma (NHL) patients.
We compared T- and B-cell subset recovery and related capability to respond to in-vitro stimulation,
as well as T-cell repertoire modifications of HIV+ and HIV− NHL patients undergoing HCT and ASCT
as first-line consolidation or salvage treatment, using sequential blood samples obtained before and
at 3, 6, 12 and 24 months after ASCT. B lymphocyte recovery occurred earlier, reaching higher levels
in HIV+ patients as compared to HIV− patients and healthy controls; in particular, immature and
naïve B cells were significantly higher in HIV+ patients who had received rituximab in the pre-ASCT
period. These lymphocytes equally responded to in-vitro stimulation. Newly produced T cells similarly
increased in HIV+ and HIV− NHL patients, but their levels remained constantly lower than in healthy
controls. T lymphocytes showed a reduced proliferative capacity, but their repertoire was reassorted
by the treatment. The functional and numeric B-cell recovery and the qualitative modifications of T-cell
receptor repertoire may explain, at least in part, the success of this aggressive therapeutic approach in
HIV+ patients.