Gemtuzumab ozogamicin for relapsed and refractory acute myeloid leukemia and myeloid sarcomas.
Antibody-targeted chemotherapy is a promising approach in patients with hematological malignancies. In particular, gemtuzumab ozogamicin (GO, formerly CMA-676), an anti-CD33 antibody linked to calicheamicin, has been approved for the treatment of elderly patients with acute myeloid leukemia (AML) in relapse. Nevertheless, no data are until now available concerning the possible efficacy of GO for myeloid sarcomas (MS). We treated with GO 24 AML patients, in 5 cases presenting with myeloid sarcomas of the skin or bones. The overall complete response rate was 21%. The median duration of response was 6 months. Four out of the 5 patients with myeloid sarcoma showed a regression of the masses, in two cases also obtaining a clearance of marrow blasts. The most common adverse events included thrombocytopenia, neutropenia, infections, elevation of bilirubin and hepatic transaminases. Notably, severe bleeding occurred in 5 cases (21%). VOD was documented in 1 case. We conclude that GO is effective as a single agent in AML and myeloid sarcomas. Further data are required to clarify the possible correlation between GO administration and occurrence of bleeding.
Piccaluga
Pier Paolo
PP
Institute of Haematology and Medical Oncology "L. and A. Seràgnoli", S. Orsola-Malpighi Hospital, University of Bologna, Italy. ppp2104@columbia.edu
Martinelli
Giovanni
G
Rondoni
Michela
M
Malagola
Michele
M
Gaitani
Stavroula
S
Isidori
Alessandro
A
Bonini
Alessandro
A
Gugliotta
Luigi
L
Luppi
Mario
M
Morselli
Monica
M
Sparaventi
Giovanni
G
Visani
Giuseppe
G
Baccarani
Michele
M
D000328:Adult; D000368:Aged; D000617:Aminoglycosides / Q000008:administration & dosage / Q000009:adverse effects / Q000276:immunology* / Q000627:therapeutic use*; D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000009:adverse effects / Q000276:immunology* / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D002423:Cause of Death; D005260:Female; D000079982:Gemtuzumab; D006801:Humans; D007167:Immunotherapy; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy* / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D023981:Sarcoma, Myeloid / Q000188:drug therapy* / Q000276:immunology*; D016896:Treatment Outcome
D000617:Aminoglycosides; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000079982:Gemtuzumab