Safety and efficacy of gemtuzumab ozogamicin in pediatric patients with advanced CD33+ acute myeloid leukemia

Robert J. Arceci, Jane Sande, Beverly Lange, Kevin Shannon, Janet Franklin, Raymond Hutchinson, Terry Vik, David Flowers, Richard Aplenc, Mark S. Berger, Matthew L. Sherman, Franklin O. Smith, Irwin Bernstein, Eric L. Sievers

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Abstract

This open-label, dose-escalation study evaluated the safety and efficacy of single-agent gemtuzumab ozogamicin, a humanized anti-CD33 antibody-targeted chemotherapeutic agent, for pediatric patients with multiple relapsed or primary refractory acute myeloid leukemia (AML). Twenty-nine children 1 to 16 years of age (relapsed disease, 19; refractory disease, 10) received gemtuzumab ozogamicin ranging from 6 to 9 mg/m2 per dose for 2 doses (separated by 2 weeks) infused over 2 hours. All patients had anticipated myelosuppression. Other toxicities included grade 3/4 hyperbilirubinemia (7%) and elevated hepatic transaminase levels (21%); the incidence of grade 3/4 mucositis (3%) or sepsis (24%) was relatively low. One patient treated at 9 mg/m2 developed veno-occlusive disease (VOD) of the liver and defined the dose-limiting toxicity. Thirteen patients underwent hematopoietic stem-cell transplantation less than 3.5 months after the last dose of gemtuzumab ozogamicin; 6 (40%) developed VOD. Eight of 29 (28%) patients achieved overall remission. Remissions were comparable in patients with refractory (30%) and relapsed (26%) disease. Mean multidrug resistance-protein-mediated drug efflux was significantly lower in the leukemic blasts of patients achieving remission (P <.005). Gemtuzumab ozogamicin was relatively well tolerated at 6 mg/m2 for 2 doses and was equally effective in patients with refractory and relapsed disease. Further studies in combination with standard induction therapy for childhood AML are warranted.

Original languageEnglish (US)
Pages (from-to)1183-1188
Number of pages6
JournalBlood
Volume106
Issue number4
DOIs
StatePublished - Aug 15 2005
Externally publishedYes

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Pediatrics
Acute Myeloid Leukemia
Safety
Refractory materials
Toxicity
P-Glycoproteins
Antibodies, Monoclonal, Humanized
Mucositis
Hyperbilirubinemia
Transaminases
Stem cells
Hematopoietic Stem Cell Transplantation
Liver
Proxy
gemtuzumab
Labels
Liver Diseases
Anti-Idiotypic Antibodies
Sepsis
Antibodies

ASJC Scopus subject areas

  • Hematology

Cite this

Arceci, R. J., Sande, J., Lange, B., Shannon, K., Franklin, J., Hutchinson, R., ... Sievers, E. L. (2005). Safety and efficacy of gemtuzumab ozogamicin in pediatric patients with advanced CD33+ acute myeloid leukemia. Blood, 106(4), 1183-1188. https://doi.org/10.1182/blood-2004-10-3821

Safety and efficacy of gemtuzumab ozogamicin in pediatric patients with advanced CD33+ acute myeloid leukemia. / Arceci, Robert J.; Sande, Jane; Lange, Beverly; Shannon, Kevin; Franklin, Janet; Hutchinson, Raymond; Vik, Terry; Flowers, David; Aplenc, Richard; Berger, Mark S.; Sherman, Matthew L.; Smith, Franklin O.; Bernstein, Irwin; Sievers, Eric L.

In: Blood, Vol. 106, No. 4, 15.08.2005, p. 1183-1188.

Research output: Contribution to journalArticle

Arceci, RJ, Sande, J, Lange, B, Shannon, K, Franklin, J, Hutchinson, R, Vik, T, Flowers, D, Aplenc, R, Berger, MS, Sherman, ML, Smith, FO, Bernstein, I & Sievers, EL 2005, 'Safety and efficacy of gemtuzumab ozogamicin in pediatric patients with advanced CD33+ acute myeloid leukemia', Blood, vol. 106, no. 4, pp. 1183-1188. https://doi.org/10.1182/blood-2004-10-3821
Arceci RJ, Sande J, Lange B, Shannon K, Franklin J, Hutchinson R et al. Safety and efficacy of gemtuzumab ozogamicin in pediatric patients with advanced CD33+ acute myeloid leukemia. Blood. 2005 Aug 15;106(4):1183-1188. https://doi.org/10.1182/blood-2004-10-3821
Arceci, Robert J. ; Sande, Jane ; Lange, Beverly ; Shannon, Kevin ; Franklin, Janet ; Hutchinson, Raymond ; Vik, Terry ; Flowers, David ; Aplenc, Richard ; Berger, Mark S. ; Sherman, Matthew L. ; Smith, Franklin O. ; Bernstein, Irwin ; Sievers, Eric L. / Safety and efficacy of gemtuzumab ozogamicin in pediatric patients with advanced CD33+ acute myeloid leukemia. In: Blood. 2005 ; Vol. 106, No. 4. pp. 1183-1188.
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