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Inicio Medicina Clínica (English Edition) Low doses of gemtuzumab ozogamicin in adults diagnosed with acute myeloid leukae...
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Vol. 157. Issue 7.
Pages 325-328 (October 2021)
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Vol. 157. Issue 7.
Pages 325-328 (October 2021)
Brief report
Low doses of gemtuzumab ozogamicin in adults diagnosed with acute myeloid leukaemia
Gemtuzumab ozogamicina a bajas dosis en adultos con leucemia mieloide aguda
Marta Peña Domingoa,
Corresponding author
mpdomingo@gmail.com

Corresponding author.
, Susana Vives Poloa, Ana Garrido Díazb, Rosa Coll Jordàc, J.M. Ribera Santasusanaa, Christelle Ferrá Colla,d
a Servicio de Hematología Clínica, Institut Català d’Oncologia-Hospital Germans Trias i Pujol, Badalona, Institut de Recerca Contra la Leucèmia Josep Carreras, Universidad Autónoma de Barcelona, Barcelona, Spain
b Servicio de Hematología Clínica, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
c Servicio de Hematología Clínica, Institut Català d’Oncologia-Hospital Universitari Josep Trueta, Girona, Spain
d Universitat de Vic, Universitat de Central de Catalunya, Vic, Barcelona, Spain
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Tables (3)
Table 1. Clinical and biological characteristics of patients with de novo AML who received GO as part of remission induction therapy and patients with refractory or relapsed AML who received GO as part of salvage therapy. Characteristics of the treatment administered in the 2 groups.
Table 2. Toxicities and response to treatment of patients with de novo AML who received GO as part of remission induction therapy and patients with refractory or relapsed AML who received GO as part of salvage therapy.
Table 3. Characteristics of patients who received HSCT after GO administration, both induction and relapsed/refractory.
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Abstract
Background

Gemtuzumab ozogamicin (GO) is a monoclonal antibody with significant activity in CD33 + acute myeloid leukaemia (AML). At doses of 9 mg/m2, its benefit was limited by hepatotoxicity and sinusoidal obstruction syndrome (SOS). Fractionated doses improved toxicity without compromising efficacy. We evaluated the efficacy and the toxicity of low doses of GO.

Methods

Twenty-four patients with AML received 3 mg/m2 of GO as a part of the induction or reinduction therapy.

Results

Fourteen patients diagnosed with de novo AML and 10 patients with relapsed or refractory (R/R) AML received GO as a part of the induction or reinduction therapy. Three and no cases of hepatotoxicity were observed, respectively. Thirteen patients received a subsequent haematopoietic stem cell transplantation (HSCT) after GO therapy. Hepatotoxicity was observed in 2 patients and no SOS was observed in any patient.

Conclusions

The administration of low dose GO is feasible and does not have impact on subsequent HSCT outcome. Although some degree of hepatotoxicity was observed, there were no cases of SOS, either before or after HSCT.

Keywords:
Gemtuzumab ozogamicin
Acute myeloid leukaemia
Sinusoidal obstruction syndrome
Hepatotoxicity
Resumen
Introducción

Gemtuzumab ozogamicina (GO) es un anticuerpo monoclonal activo frente la leucemia mieloide aguda (LMA) CD33+. A dosis de 9 mg/m2, su beneficio se vio limitado por la hepatotoxicidad y el síndrome de oclusión sinusoidal (SOS). Dosis fraccionadas (3 mg/m2) mejoraron la toxicidad sin comprometer la eficacia. En este estudio se evaluó la eficacia y la toxicidad de GO administrado a dosis bajas.

Métodos

Se incluyeron 24 pacientes con LMA tratados con GO a dosis de 3 mg/m2 durante el tratamiento de inducción o reinducción.

Resultados

Catorce pacientes con LMA de novo y 10 con LMA en recaída o refractaria (R/R) recibieron GO como parte del tratamiento de inducción o reinducción. Se observó hepatotoxicidad grado 3–4 en 3 y ningún paciente, respectivamente. Trece pacientes recibieron posteriormente un trasplante de progenitores hematopoyéticos (TPH) observándose en ellos 2 casos de hepatotoxicidad y ningún caso de SOS.

Conclusiones

La administración de GO a dosis de 3 mg/m2 es segura y no compromete la realización de un ulterior TPH. Aunque la hepatotoxicidad fue frecuente, no se observó SOS antes o después del TPH.

Palabras clave:
Gemtuzumab ozogamicina
Leucemia aguda mieloblástica
Síndrome de oclusión sinusoidal
Hepatotoxicidad

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