AIDS-related non-Hodgkin's lymphoma is a frequently fatal and increasingly common complication of immunosuppression induced by HIV-l. At present, there are no satisfactory therapies for the approximately 75% of patients who either fail or relapse after conventional chemotherapy. One lesson from lymphomas in other immunosuppressed populations, is the regression of some of these tumors upon withdrawal of the immunosuppressive agent and restoration of host immunologic response. Similarly, it has been documented in other hematologic malignancies treated by bone marrow transplant, that donor cells reactive to host tumor cells are transplanted and may have a significant impact on the remission status of the host. Although the induction of endogenous host responses to lymphoma is not yet possible in the setting of HIV-1 disease, it may be possible to passively transfer tumor-reactive immune cells from related donors. Prior protocols for bone marrow transplant in AIDS lymphoma have indirectly tested this issue, but have been accompanied by unacceptable high transplant related mortality. This proposal seeks to test the possibility of inducing anti- tumor effects through the transfer of allogeneic or haploidentical peripheral blood mononuclear cells (PBMC) without prior bone marrow ablative therapy in patients with relapsed or refractory AIDS lymphoma.
