BONE MARROW TRANSPLANTATION FOR HIV PATIENTS WITH CANCER

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This project requests support for preclinical and clinical studies evaluating the role of bone marrow transplantation (BMT) and antiviral chemotherapy in the treatment of HIV-l positive patients with hematologic malignancy. Three specific aims are addressed. In Aim 1, we plan to determine whether intensive therapy followed by BMT can eliminate the reservoir of HIV-l infected cells and if 3'-azido-3'deoxythymidine (AZT) can prevent infection of transplanted donor cells obtained from allogeneic bone marrow. In Aim 2, we plan to determine which lympho-hematopoietic cells in HIV-l positive patients carry the virus to determine whether the virus is present in stem cells and what fraction of cells are infected with HIV-l in patients at different stages of their disease. In Aim 3, we plan to investigate whether pluripotent lympho-hematopoietic stems free of HIV-l can be generated with ex vivo bone marrow manipulation and "purging" techniques. If this aim is successful it will lead to consideration of autologous BMT as therapy for patients with HIV-l infection.