Stem cell transplant from HLA-matched CCR5-delta 32 deleted donor suppresses viraemia

Stem cell transplant from HLA-matched CCR5-delta 32 deleted donor suppresses viraemia in recipient for eight months without HAART

One of the most interesting and intriguing posters at the conference was a case study presented by Gero Hutter from the Medical University of Berlin.

The patient, a 40-year-old man diagnosed in 1995, experienced a relapse of acute myeloid leukemia (AML) that was first diagnosed in 2006. He underwent allogeneic transplant of peripheral stem cells (alloSCT) with an HLA-matched donor, selected to be homozygous for CCR5-delta 32.

A bone marrow registry search identified 232 individuals who had matched HLA, and PCR identified homozygousity for CCR5-d32. HAART was stopped on the day of the transplant. GvHD prophylaxis followed standard regimens and engraftment was achieved on day 13. Complete chimerismas detected by competitive PCR was observed on day 60.

Viral load was measured both by RNA-PCR and proviral DNA-PCR. DNA-PCR was negative from day +68.

Translation: HIV infected patient has a relapse of lukemia. Stem cells are selected for transplant, however with one catch: they are from a donor with the CCR5delta32 mutation.

Result: It fought the HIV infection better than any medication we have ever discovered. Evolutionary biology presents us a key for fighting a virus with no known cure.

Science. It works.