title: Successful repeated treatment of acute myeloid leukemia in early relapse with gemtuzumab ozogamicin alone.
abstract: A 68-year-old female was diagnosed with acute myeloid leukemia (AML-M2 without 8/21 translocation) in December 2006. Although a complete remission (CR) was obtained after induction chemotherapy, the first post-remission therapy was discontinued because of severe cardiovascular complications. She had a relapse of AML with CD33-positive myeloblasts which comprised 38.4 % of the bone marrow cells in November 2007. She received two courses of low-dose chemotherapy because of the previous complications. The amount of Wilm's tumor 1 (WT1) mRNA in the peripheral blood was 13,000 copies/μg RNA after the first course of the chemotherapy, and 4.8 % myeloblasts remained in the bone marrow after the second course. She was treated with a single course of gemtuzumab ozogamicin (GO), with a subsequent CR with 0.9 % marrow myeloblasts and fewer than 50 copies of WT-1 mRNA (normal level). Thereafter, she received five courses of GO monotherapy at each occasion of early AML relapse. Hematological remission has been sustained over a period of about 24 months with the GO monotherapy alone. This case suggests that GO monotherapy is a useful salvage therapy for early relapse of CD33-positive AML in situations in which standard chemotherapy is not indicated.
authors.affiliation: Department of Hematology, Shinko Hospital, 4-47 Wakihama-cho, 1-chome, Chuo-ku, Kobe, 651-0072, Japan.
authors.forename: Hiroko
authors.initials: H
authors.lastname: Tsunemine
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Akasaka
authors.forename: Emiko Ishikawa
authors.initials: EI
authors.lastname: Sakane
authors.forename: Kiminari
authors.initials: K
authors.lastname: Ito
authors.forename: Taiichi
authors.initials: T
authors.lastname: Kodaka
authors.forename: Takayuki
authors.initials: T
authors.lastname: Takahashi
mesh_terms: 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; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy* / Q000517:prevention & control; D012074:Remission Induction; D016879:Salvage Therapy / Q000009:adverse effects; D055502:Secondary Prevention; D016896:Treatment Outcome
chemical_list: D000617:Aminoglycosides; D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents; D000079982:Gemtuzumab