Hematopoietic stem cell transplant following remission induction chemotherapy including gemtuzumab ozogamicin is a feasible and effective treatment option in elderly patients with acute myeloid leukemia.
This study analyzed the results of stem cell transplant (SCT) in elderly patients with acute myeloid leukemia (AML) who achieved complete remission (CR) with a gemtuzumab ozogamicin (GO)-containing regimen in order to identify the impact of the drug as a remission induction regimen on the outcome of SCT. Patients who achieved CR with GO proceeded to reduced-intensity conditioning or autologous SCT after one or two cycles of consolidation chemotherapy. With a median follow-up of 53.5 months (n - 17), probabilities of overall survival (OS) and disease-free survival (DFS) at 3 years were 58.2 ± 12.1% and 47.1 ± 12.1%, respectively, and the cumulative incidences of relapse and non-relapse mortality were 35.3 ± 12.1%, and 17.7 ± 9.5%, respectively. Patients with high bone marrow CD33 expression at the time of diagnosis showed significantly higher OS and DFS (70.7%, p = 0.008 and 57.1%, p = 0.008, respectively) than those with low expression. The intensification of post-remission treatment using SCT in elderly patients with AML who achieve CR on GO appears to be an effective and feasible treatment modality.
Division of Hematology, Department of Internal Medicine, Yeouido St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Ki-Seong
KS
Eom
Hee-Je
HJ
Kim
Byung-Sik
BS
Cho
Su-Mi
SM
Choi
Dong-Gun
DG
Lee
Seung-Eun
SE
Lee
Seung-Ah
SA
Yahng
Yoo-Jin
YJ
Kim
Seok
S
Lee
Chang-Ki
CK
Min
Seok-Goo
SG
Cho
Dong-Wook
DW
Kim
Jong-Wook
JW
Lee
Chong-Won
CW
Park
Woo-Sung
WS
Min
D000368:Aged; D000617:Aminoglycosides / Q000009:adverse effects / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000009:adverse effects / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D000079982:Gemtuzumab; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects; D006801:Humans; D060828:Induction Chemotherapy; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D016019:Survival Analysis; D016896:Treatment Outcome
D000617:Aminoglycosides; D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents; D000079982:Gemtuzumab