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Efficacy of fractionated gemtuzumab ozogamicin combined with cytarabine in advanced childhood myeloid leukaemia
Author(s) -
Brethon Benoit,
Yakouben Karima,
Oudot Caroline,
Boutard Patrick,
Bruno Bénédicte,
Jérome Cécile,
Nelken Brigitte,
De Lumley Lionel,
Bertrand Yves,
Dalle JeanHugues,
Chevret Sylvie,
Leblanc Thierry,
Baruchel André
Publication year - 2008
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/j.1365-2141.2008.07370.x
Subject(s) - gemtuzumab ozogamicin , medicine , cytarabine , tolerability , refractory (planetary science) , adverse effect , gastroenterology , surgery , cd33 , leukemia , stem cell , cd34 , genetics , physics , astrobiology , biology
Summary Gemtuzumab ozogamicin (GO) monotherapy is reported to yield a 20–30% response rate in advanced acute myeloid leukaemia (AML). This study examined the efficacy and tolerability of GO combined with cytarabine (GOCYT) in children with refractory/relapsed CD33 + AML. Seventeen children received GO 3 mg/m 2 on days 1, 4 and 7 plus cytarabine 100 mg/m 2 /d for 7 d on a compassionate‐use basis. Seven patients then received GO‐based consolidation. At the outset of GOCYT, two patients were refractory; eight patients were in refractory first relapse; six patients had relapsed after stem cell transplantation (SCT); and one patient [del(5q) therapy‐related AML (t‐AML)] had not yet been treated. Mean follow‐up was 17 months (8–33 months). Ten responses were obtained after GOCYT induction, including complete remission (CR) or CR without complete recovery of platelets (CRp) in six patients (35%). The responses improved in three children who received GOCYT consolidation, increasing the CR + CRp rate to 53%. SCT was subsequently performed in eight responders. Grade 3–4 adverse events consisted of haematological disorders ( n = 17, 100%) and documented infections ( n = 5, 29%). No cases of sinusoidal obstructive syndrome occurred. Three patients were alive at the cut‐off date for this analysis, all of whom had responded to GOCYT. GOCYT combination therapy yielded a high response rate (53%) and showed acceptable toxicity in heavily pretreated children with refractory/relapsed AML. These results warrant a larger prospective study.