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Veno‐occlusive disease risk in pediatric patients with acute myeloid leukemia treated with gemtuzumab ozogamicin before allogeneic hematopoietic cell transplantation
Author(s) -
Duncan Christine,
St. Martin Andrew,
Pérez Waleska S.,
Steinert Patricia,
Zhang MeiJie,
Chirnomas Deborah,
Hoang Caroline J.,
Loberiza Fausto R.,
Saber Wael
Publication year - 2021
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.29067
Subject(s) - gemtuzumab ozogamicin , medicine , hepatic veno occlusive disease , hematopoietic stem cell transplantation , myeloid leukemia , hematopoietic cell , oncology , disease , transplantation , haematopoiesis , stem cell , cd33 , cd34 , genetics , biology
Background Gemtuzumab ozogamicin (GO) administered before allogeneic hematopoietic cell transplantation (alloHCT) has been linked to an increased risk of hepatic veno‐occlusive disease/sinusoidal obstruction syndrome (VOD/SOS). Procedure This retrospective analysis examined VOD/SOS risk and clinical outcomes in pediatric patients with acute myeloid leukemia who received myeloablative alloHCT in 2008–2011 with ( n = 148) and without ( n = 348; controls) prior GO exposure and were reported to the Center for International Blood and Marrow Transplant Research. Results Cumulative incidences (95% confidence interval [CI]) of VOD/SOS and severe VOD/SOS, respectively, at 100 days were 16% (11–23%) and 8% (4–13%) for GO‐exposed patients and 10% (7–13%) and 3% (2–5%) for controls. With a median follow‐up of approximately 7 years, the 5‐year adjusted overall survival probability (95% CI) after alloHCT was 51% (43–58%) and 55% (50–60%) for GO‐exposed patients and controls, respectively; three (4%) and one (<1%) deaths were attributed to VOD/SOS. In multivariate analyses, GO exposure was observed to be associated with an increased risk of VOD/SOS at 100 days, but was not associated with overall survival, disease‐free survival, relapse, or nonrelapse mortality. Conclusions Results suggest that GO treatment prior to alloHCT in pediatric patients may increase the risk of VOD/SOS but not death.