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Leukemic gingival infiltrate as an indicator of chemotherapeutic failure following monoclonal antibody therapy: a case report
Author(s) -
Sollecito Thomas P.,
Draznin Julia,
Parisi Ernesta,
Duffy Kathleen,
Stadtmauer Edward A.,
Luger Selina M.,
Schuster Stephen J.,
Tsai Donald,
Porter David L.
Publication year - 2003
Publication title -
special care in dentistry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.328
H-Index - 41
eISSN - 1754-4505
pISSN - 0275-1879
DOI - 10.1111/j.1754-4505.2003.tb01670.x
Subject(s) - medicine , monoclonal antibody , monoclonal , antibody therapy , monoclonal antibody therapy , immunology , pathology , antibody
Treatment options are limited for patients with relapsed acute myelogenous leukemia (AML), particularly when the disease is refractory to standard cytotoxic chemotherapy. Targeted drug therapy offers the advantage of delivering higher doses of non‐cross‐resistant chemotherapy with potentially less systemic toxicity. Gemtuzumab ozogamicin (Mylotarg, Wyeth‐Ayerst Laboratories) is an immunoconjugate that consists of humanized anti‐CD 33 antibody linked to the potent anti‐tumor antibiotic calicheamicin and has been an effective therapy for some patients with relapsed AML. However, the overall utility of gemtuzumab ozogamicin is not well defined. For instance, it is not known how well this antibody will target extramedullar/ disease. This article reports gemtuzumab treatment of refractory AML in a 32–year‐old man. At the time of recurrence, his bone marrow was hypoplastic and without leukemia, but the condition progressed resulting in marked leukemic infiltration of the oral mucosa. This case history raises the possibility that leukemic sanctuary sites may exist, and that monoclonal antibody therapy may have sub‐optimal activity in non‐medullary sites of disease.