21 February 2024

A patient, aged 68, has become the oldest to achieve remission for both leukaemia and HIV through a stem cell transplant, it has been announced.

The patient, named as Paul Edmonds, is thought to be the fifth known patient to experience a double cure from a transplant, after being given donor cells known to be resistant to HIV because they carried the genetic mutation homozygous CCR5-Δ32.

The patient had been infected with the virus for 31 years. Reporting in the New England Journal of Medicine, his doctors at City of Hope, Los Angeles, USA say the success of the procedure shows it can work for older patients.

Mr Edmonds stopped taking antiretrovirals for HIV three years ago and will not be deemed to be cured until he has spent another two years in remission.

In preparation for his transplant to cure his acute myelogenous leukaemia (AML), he received a reduced-intensity chemotherapy conditioning regimen designed at the hospital to be tolerable for older patients.

Following the transplant, he developed moderate graft v host disease. However, he achieved full chimerism, giving him a cure from his AML and HIV resistance.

Researcher Professor Jana Dickter said: “City of Hope’s case demonstrates that it is possible to achieve remission from HIV even at an older age and after living with HIV for many years. Furthermore, remission can be achieved with a lower-intensity regimen than the therapy received by the four other patients who went into remission for HIV and cancer. As people with HIV continue to live longer, there will be more opportunities for personalised treatments for their blood cancers.”

Professor Stephen Forman, director of City of Hope’s Hematologic Malignancies Research Institute, said: “City of Hope is not stopping there. Our researchers are working on creating stem cells that have the genetic mutation that makes them naturally resistant to HIV, among other research initiatives.”


Dickter JK, Aribi A, Cardoso AA, Gianella S, Gendzekhadze K, Li S, Feng Y, Chaillon A, Laird GM, Browning DL, Ross JA, Nanayakkara DD, Puing A, Stan R, Lai LL, Chang S, Kadambi TD, Thomas S, Al Malki MM, Nakamura R, Alvarnas J, Taplitz RA, Dadwal SS, Forman SJ, Zaia JA. (2024) “HIV-1 Remission after Allogeneic Hematopoietic-Cell Transplantation.” New England Journal of Medicine, doi: 10.1056/NEJMc2312556

Link: https://www.nejm.org/doi/pdf/10.1056/NEJMc2312556

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