(22). In this patient, peripheral CD4 counts increased and peaked 
approximately 3 months after transplantation, along with the new appearance 
of delayed-type hypersensitivity responses. However, these changes were 
transient, and there was no sustained immunologic or clinical improvement. 
Other investigators have reported on the use of both syngeneic and 
allogeneic bone marrow transplantation in AIDS patients arid on treatment 
with peripheral lymphocyte infusions, also resulting in only temporary 
immunologic improvement (23-27). 
More recently, we reported on 16 HIV infected patients treated with 
zidovudine for 12 weeks followed by 6 peripheral lymphocyte infusions and 
syngeneic bone marrow transplantation (28). Following transplantation, 
patients were randomized to receive either zidovudine or placebo for 12 
months. Again, temporary improvement in immune function resulted, lasting 
1 to 2 months, and no sustained clinical improvement was seen. This study 
confirmed earlier reports on the safety of adoptive transfer of peripheral 
lymphocytes and syngeneic bone marrow transplantation combined with 
antiretroviral agents such as zidovudine in HIV-infected persons. One patient 
developed transient generalized erythema after the first lymphocyte infusion, 
and one patient was febrile after bone marrow transplantation. Both 
problems resolved within 48 hours. 
A current intramural protocol (Protocol 90-1-0076) is investigating the 
effects of combined zidovudine, interferon alpha, recombinant CD4-lgG, and 
transplantation of syngeneic bone marrow with peripheral blood lymphocyte 
transfers from gp160-immunized donors in patients with HIV infection: All 3 
HIV-infected patients enrolled in this study have received their lymphocyte 
transfers and bone marrow transplants, and no significant adverse effects 
have occurred to date. 
A related intramural protocol (Protocol 92-1-0035) examines the 
immunologic and antiretroviral effects of the adoptive transfer of a nef-specific 
CTL clone when reinfused to the seropositive donor from whom it was 
derived. To date, this patient has received a total of 28 x 109 CTL infused in 3 
escalating divided doses one week apart, followed by IL-2 infusions, 17,000 
units q8hrs for a total of 7 doses. CD4 counts in this patient went from an 
average of 300 cells/mm3 prestudy to 700 cells/mm3 one week post 
completion of infusions, and have since returned to baseline. While the IL-2 
infusions were prematurely discontinued in this patient due to toxicity (which 
included reversible thrombocytopenia, leukopenia, hepatic enzyme 
abnormalities, and mental status changes), the cell infusions themselves 
were well tolerated. 
Recombinant DNA Research, Volume 16 
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