A California man is about to be declared cured of HIV and blood cancer.
Paul Edmonds, 68, who made international headlines last year when he shared his story, still has no signs of either condition after five years.
In a new article from the medical team that treated him, doctors said he had been officially cured of cancer and that in two years he would be declared cured of HIV – even though he would have been without HIV medication for five years.
But Mr. Edmonds’ journey was tumultuous. He was diagnosed with AIDS in 1988, at a time when the virus was often a death sentence.
Despite watching so many of his friends die from the infection, he persevered and lived happily married to his husband, until a devastating leukemia diagnosis in 2018 seemed to ruin their future plans.
He was being treated for the cancer with stem cell therapy, in which stem cells damaged by chemotherapy are replaced with healthy cells from a donor – when doctors saw a unique opportunity to find a donor with an HIV-resistant genetic mutation.
Paul Edmonds, 68, (pictured) became the fifth person ever to be cured of HIV after a rare stem cell treatment
In February 2019, Mr. Edmonds received stem cells from his donor
Mr. Edmonds is one of only five to beat both diseases and the oldest person to do so.
“I’m extremely grateful … I can’t thank them enough,” Mr. Edmonds said of his doctors at the City of Hope clinic in California.
Mr. Edmonds of Desert Hot Springs, Riverside County, received a stem cell transplant, the final part of treatment for blood cancers such as leukemia and lymphoma, which kill the blood-forming stem cells in a patient’s bone marrow. by radiation or chemotherapy.
Stem cells are special human cells that can develop into many different cell types, such as muscle cells or brain cells.
Healthy, blood-producing stem cells from a donor with similar genes are transplanted into the patient, allowing them to produce cancer-free blood.
In Mr. Edmonds’ case, the donated stem cells also had a rare genetic mutation linked to resistance to HIV-1.
He was diagnosed with HIV and AIDS in 1988, at the height of the national epidemic, which he says felt like a death sentence.
“People died within a few years of finding out they were positive,” he said of his experience with AIDS in San Francisco in the 1980s. “There was a dark cloud hanging over the city.”
Mr Edmonds had been receiving antiretroviral therapy for HIV since 1997, which had suppressed his virus to undetectable levels.
But the therapy does not completely cure HIV, so the virus was always present in his immune cells in the blood.
This means that if therapy is stopped, the virus begins to multiply and becomes detectable in the blood again.
He was diagnosed with leukemia in 2018. Older patients with HIV often develop blood cancers because of their weakened immune systems.
Mr Edmonds’ cancer – acute myeloid leukemia (AML) – is a form of blood cancer that starts in young white blood cells in the bone marrow.
About 19,500 new cases occur in the U.S. each year.
Symptoms may include: fatigue, fever, frecent infections, beasy rustling or bleeding, including nosebleeds or heavy periods, and weight loss.
The exact cause of AML is unclear.
Transplant patients must first go into remission for cancer, which usually requires intensive chemotherapy so that the cancer cells are removed.
Giving chemotherapy to patients receiving IV antiretroviral therapy, as Mr. Edmonds did, can be difficult because chemotherapy can briefly undermine a patient’s immune system.
In November 2018, Mr. Edmonds began chemotherapy. He needed three rounds to achieve remission, which was achieved in mid-January 2019.
The following month, Mr. Edmonds received stem cells from his donor.
The stem cells he received contained two copies of a rare genetic mutation called CCR5 delta-3, which makes people resistant to HIV.
Only one to two percent of the population has this mutation.
HIV uses the receptor CCR5 to invade and attack the immune system, but the CCR5 mutation prevents the virus from entering this way.
The transplant completely swapped Mr. Edmond’s bone marrow and blood stem cells with those of the donor.
Since the transplant, he has shown no signs of AML or HIV.
Mr Edmonds is one of only five people worldwide to have gone into remission following a stem cell transplant.
“The case of City of Hope shows that it is possible to achieve remission from HIV even at an older age and after living with HIV for many years,” said Dr. Jana Dickter, clinical professor in the Department of Infectious Diseases at City of Hope.
‘Additionally, 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 options for personalized treatments for their blood cancer,” she added.
The case was described in the New England Journal of Medicine.
Dr. Stephen Forman, a professor in the Department of Hematology and Hematopoietic Cell Transplantation, said the hospital “didn’t stop there.”
“Our researchers are working, among other things, to create stem cells with the genetic mutation that makes them naturally resistant to HIV,” he said.