Patients who may have been cured of HIV infection by special stem cell transplantation

According to Weill Cornell Medicine and New York-Presbyterian, patients living with HIV who have undergone hematopoietic stem cell transplantation for high-risk acute myeloid leukemia have been treated without the virus for 14 months after discontinuing HIV antiretroviral drug treatment. The law is suggested. A doctor-scientist who transplanted and managed her care.

Like the other two successful cases reported, the transplanted donor cells had mutations that made them resistant to HIV infection.

A new case of long-term HIV remission was reported at the 29th Annual Conference on Retroviruses and Opportunistic Infections in Denver on February 15.

The patient underwent transplantation of blood cells and immunocyte-replenishing stem cells after destroying her own blood cell population, including leukemia cells, by high-dose chemotherapy. The transplanted cells came from two sources: stem cells from healthy adult relatives were used to quickly restore her blood cell population to reduce infectious complications and from unrelated neonates. Cord blood was used to provide long-term blood reconstitution.

Cord blood is used to supply blood stem cells for transplantation for patients who cannot find a matching adult donor. Transplant experts have found that cord blood can be used successfully even when the immune marker comes from an unrelated donor who only partially matches the recipient’s immune marker.

The doctor in this case used cord blood containing an HIV resistance gene variant called CCR5.Δ32. HIV usually uses the CCR5 co-receptor to help infect immune cells, but the receptor does ΔThe 32 variants effectively block the invasion of viruses.

Three months after transplantation, tests showed that the patient’s blood cell population was entirely derived from HIV-resistant umbilical cord blood cells. Post-transplant studies have failed to detect HIV with a variety of sensitive assays. Patients eventually stopped taking antiretroviral drugs to control HIV infection, have not taken HIV drugs for 14 months so far, and after close follow-up during a COVID 19 pandemic, HIV There are no signs of reappearance, indicating a possible cure. Doctors at this stage prefer to call it long-term remission. She has also been leukemia-free for over four years.

Two previous cases of long-term remission in HIV-positive cancer patients after adult CCR5Δ32 stem cell transplants have been reported. This is the first case of using umbilical cord blood cells and the first case of treating a person identified as having mixed blood with a female. CCR5 or laterΔ32 variants are much more common in people of European heritage and it is difficult to find a well-matched CCR5ΔThe use of cord blood partially alleviates this problem, but 32 donors for traditional stem cell transplantation into non-white patients.

Dr. Jingmei Hsu and Dr. Koen Van Besien, experts in stem cell transplantation, and Dr. Marshall Glesby, experts in infectious diseases, NIH-funded clinical trials At Weil Cornell Medicine in collaboration with researchers at the University of California, Los Angeles, Johns Hopkins University School of Medicine and several other institutions.

Researchers have found that cord blood, including CCR5,ΔThe 32 variants provide possible therapies for both hematological malignancies and HIV and should be considered a stem cell source if HIV-positive cancer patients require blood stem cell transplantation. However, this procedure is considered too risky for HIV-positive patients who would otherwise not require such a transplant.

Many Weill Cornell Medicine physicians and scientists maintain relationships and collaboration with external organizations to promote scientific innovation and provide professional guidance. Weill Cornell Medicine and its faculty have made this information publicly available to ensure transparency. External information is available on the faculty profile. Dr. Jinmei Sue, Dr. Koen Van BesienWhen Dr. Marshall Gresby..

Jim Schnabel is a freelance writer for Weil Cornell Medicine.