Berlin HIV Case Report - what a break if the German Red Cross donoated the two allogenic Peripheral Blood Stem Cells for this HIV transplant cure.
A 40-year-old white man with newly diagnosed acute myeloid leukemia (FAB M4 subtype, with normal cytogenetic features) presented to our hospital. HIV-1 infection had been diagnosed more than 10 years earlier, and the patient had been treated with HAART (600 mg of efavirenz, 200 mg of emtricitabine, and 300 mg of tenofovir per day) for the previous 4 years, during which no illnesses associated with the acquired immunodeficiency syndrome (AIDS) were observed. At the time that acute myeloid leukemia was diagnosed, the patient's CD4 T-cell count was 415 per cubic millimeter, and HIV-1 RNA was not detectable (stage A2 according to classification by the Centers for Disease Control and Prevention). Initial treatment of the acute myeloid leukemia consisted of two courses of induction chemotherapy and one course of consolidation chemotherapy. During the first induction course, severe hepatic toxic effects developed and renal failure occurred. Consequently, HAART was discontinued, leading to a viral rebound (6.9x106 copies of HIV-1 RNA per milliliter). The therapy was resumed immediately, before a viral steady state was reached, and 3 months later, HIV-1 RNA was undetectable.
Seven months after presentation, acute myeloid leukemia relapsed, and the patient underwent allogeneic stem-cell transplantation with CD34+ peripheral-blood stem cells from an HLA-identical donor who had been screened for homozygosity for the CCR5 delta32 allele. The patient provided informed consent for this procedure, and the protocol was approved by the institutional review board. The HLA genotypes of the patient and the donor were identical at the following loci: A*0201; B*0702,3501; Cw*0401,0702; DRB1*0101,1501; and DQB1*0501,0602. The patient underwent a conditioning regimen and received a graft containing 2.3x106 CD34+ cells per kilogram of body weight.5 Prophylaxis against graft-versus-host disease consisted of 0.5 mg of rabbit antithymocyte globulin per kilogram 3 days before transplantation, 2.5 mg per kilogram 2 days before, and 2.5 mg per kilogram 1 day before. The patient received two doses of 2.5 mg of cyclosporine per kilogram intravenously 1 day before the procedure and treatment with mycophenolate mofetil at a dose of 1 g three times per day was started 6 hours after transplantation. HAART was administered until the day before the procedure, and engraftment was achieved 13 days after the procedure. Except for the presence of grade I graft-versus-host disease of the skin, which was treated by adjusting the dosage of cyclosporine, there were no serious infections or toxic effects other than grade I during the first year of follow-up. Acute myeloid leukemia relapsed 332 days after transplantation, and chimerism transiently decreased to 15%. The patient underwent reinduction therapy with cytarabine and gemtuzumab and on day 391 received a second transplant, consisting of 2.1x106 CD34+ cells per kilogram, from the same donor, after treatment with a single dose of whole-body irradiation (200 cGy). The second procedure led to a complete remission of the acute myeloid leukemia, which was still in remission at month 20 of follow-up.
What is pretty interesting is the American treated received a transplant for leukemia from Charite - Universitaetsmedizin Berlin:
Current Status: Registered
Last Annual Registration Year: 2010
FDA Establishment Identifier (FEI): 3001919105
Establishment Name: Charite - Universitaetsmedizin Berlin
Address: Institut fuer Transfusionsmedizin (CCM)
Chariteplatz 1
City: Berlin
State:
Zip: 10117
Country: Germany
Types of HCT/P's
Peripheral Blood Stem Cells
Therapeutic Cells
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Current Status: Registered
Last Annual Registration Year: 2010
FDA Establishment Identifier (FEI): 3006216369
Establishment Name: DRK Blutspendedienst NSTOB
Address: Transfusion Medicine
Apheresis & Stem Cell Laboratory
Brandenburger Str. 21
City: Oldenburg
State:
Zip: D-26133
Country: Germany
Types of HCT/P's
Peripheral Blood Stem Cells
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Do we own the German Red Cross Peripheral Blood and Therapy too from the Stellacure deal???
Current Status: Registered
Last Annual Registration Year: 2010
FDA Establishment Identifier (FEI): 3004618403
Establishment Name: German Red Cross Blood Service
Address: Baden Wurttemberg - Hessen
Sandhof Str 1
City: Frankfurt
State:
Zip: D-60528
Country: Germany
Types of HCT/P's
Peripheral Blood Stem Cells
Therapeutic Cells
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