Baboon bone-marrow xenotransplant in a patient with advanced HIV disease: case report and 8-year follow-up.
Baboon bone-marrow xenotransplant in a patient with advanced HIV disease: case report and 8-year follow-up.
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晚期艾滋病患者的狒狒骨髓异种移植：病例报告和 8 年随访。
DOI：
10.1097/01.tp.0000141365.23479.4e
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发表时间：
2004
期刊：
影响因子：
6.2
通讯作者：
Ildstad,SuzanneT
中科院分区：
文献类型：
--
作者：
Michaels,MarianG;Kaufman,Christina;Volberding,PaulA;Gupta,Phalguni;Switzer,WilliamM;Heneine,Walid;Sandstrom,Paul;Kaplan,Lawrence;Swift,Patrick;Damon,Lloyd;Ildstad,SuzanneT
Background.Xenotransplantation offers a solution to the shortage of organ donors and may offer resistance to human-specific pathogens. Baboons are resistant to productive infection with HIV-1. A baboon bone-marrow transplant (BMT) was performed in an attempt to reconstitute the immune system of a patient with advanced AIDS. The aims of this pilot study were to evaluate the safety of the procedure and develop an approach to prevent and monitor for xenozoonoses.Methods.A source animal was selected on the basis of infectious disease surveillance protocols. Baboon bone marrow, engineered to remove graft-versus-host-disease-producing mature lineages, but to retain hematopoietic stem cells and facilitating cells, was infused into the patient after nonmyeloablative conditioning. Serial clinical, virologic, immunologic, and hematologic evaluations were performed.Results.A 38-year-old male with advanced AIDS, who had failed to respond to triple-drug antiretroviral therapy, underwent baboon BMT in 1995. The patient tolerated the procedure without complication. Baboon cells were detected in the peripheral blood on days 5 and 13 after transplantation. Baboon endogenous virus (BaEV) was detected on day 5 but not subsequently. Antibody to BaEV was not detected. HIV-1 viral load declined 1.5 log and remained low until 11 months. The patient improved clinically, and no adverse events occurred. The patient is alive 8 years after the procedure.Conclusions.Baboon BMT to treat AIDS was attempted using nonmyeloablative conditioning and resulted in transient microchimerism and clinical and virologic improvements. Long-term improvement was not achieved; however, no adverse events occurred, and no evidence of transmission of xenogeneic infections was found.
