Clinical and Radiographic Response of Extramedullary Leukemia in Patients Treated With Gemtuzumab Ozogamicin

McNeil, Michael J.; Parisi, Marguerite T.; Hijiya, Nobuko; Meshinchi, Soheil; Cooper, Todd M.; Tarlock, Katherine

doi:10.1097/mph.0000000000001201

Cited by 10 publications

(6 citation statements)

References 19 publications

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“…The response to mono-GO, or in combination with azacitidine, that has been previously described in relapsed and refractory AML patients, even with extramedullary involvement [9][10][11], the immediate response to GO in critically ill patients with pulmonary or renal failure has not been reported. Nevertheless, the mechanism of GO pharmacokinetics provides some explanation for this prompt effect.…”

Section: Discussionmentioning

confidence: 93%

Rapid Efficacy of Gemtuzumab Ozogamicin in Refractory AML Patients with Pulmonary and Kidney Failure

Zaytsev

Girshova

Иванов

et al. 2020

Biology

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Objectives: To the best of our knowledge, data from Gemtuzumab ozogamicin in Acute Myeloid Leukemia (AML) patients with failure of organ functions and poor performance status are extremely lacking. Moreover, the fast recovery from organ failure, after Gemtuzumab ozogamicin administration, has never been reported. This study aimed to demonstrate the efficacy and rapid response of Gemtuzumab ozogamicin in refractory acute myeloid leukemia (AML) patients with pulmonary and kidney failure and poor performance status. Three refractory AML patients, with organ dysfunction, are described. One patient was pre-treated with intensive chemotherapy, and two other patients progressed during Azacitidine treatment. Two patients had respiratory failure grade 2 and one patient suffered from acute kidney insufficiency. Two patients were highly febrile with an elevated C-Reactive Protein (CRP) level. The WHO performance status of three was measured in all patients. Gemtuzumab ozogamicin administration was performed in three patients, followed by a further switch to Gemtuzumab ozogamicin + Azacitidine or "7+3" treatment. Results: Gemtuzumab ozogamicin administration resulted in abrupt fever cessation in two febrile patients simultaneously with a rapid decrease in CRP level and fast resolution of respiratory failure. Recovery of kidney function was noticed rapidly in patients with renal insufficiency. The WHO performance status was elevated in all three patients. No adverse grade II-III effects were noticed. Further treatment made two patients eligible for intensive chemotherapy, one patient underwent allogeneic stem cell transplantation, and the patient with kidney failure obtained complete remission. Conclusions: Gemtuzumab ozogamicin therapy appeared to be safe and highly efficacious in relapsed/refractory AML patients with organ dysfunction, like pulmonary or renal failure and poor performance status, and may contribute to rapid recovery from organ failures.Biology 2020, 9, 28 2 of 8 Relapsed and refractory AML (10-40% of AML) represents the most common group of AML patients with organ dysfunction and poor outcomes [3].Low toxicity of Gemtuzumab ozogamicin (GO) seems to provide a new, promising option for the treatment of highly compromised patients. Amadori et al. reported the results of the GIMEMA trial of GO versus best supportive care in the treatment of unfit for intensive chemotherapy patients in a front-line setting [4]. The toxicity of GO was comparable to best supportive care, whereas a statistically significant increase in overall survival was shown in the GO arm. Moreover, GO has been shown to be an efficacious treatment in relapse/refractory AML patients [5,6]. However, significant organ dysfunction was the exclusion criterion in all these trials. To the best of our knowledge, data of GO in AML patients with organ failure are lacking.Here, we describe three patients with refractory CD 33+ AML and organ failures who benefited from GO use. All of them had uncontrolled leukemic overgrowth. The WHO performance status got ...

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Section: Discussionmentioning

confidence: 93%

Rapid Efficacy of Gemtuzumab Ozogamicin in Refractory AML Patients with Pulmonary and Kidney Failure

Zaytsev

Girshova

Иванов

et al. 2020

Biology

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“…As it is the response to mono GO or in combination with Azacitidine has been previously described in R/R AML patients even with extramedullary involvements (17,18,19), although, nobody report the immediate response to Gem. Nevertheless, Mechanism of GO pharmacokinetics provides explanation for this prompt effect.…”

Section: Discussionmentioning

confidence: 97%

Rapid Efficacy of Gemtuzumab Ozogamicin in Refractory AML Patients with Organ Dysfunctions

Zaytsev¹,

Girshova²,

Ivanov³

et al. 2019

Preprint

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Objectives: To demonstrate the efficacy of Gemtuzumab ozogamicin in refractory AML patients with organ dysfunctions and poor performance status. Three refractory AML patients with are described. One of them was pretreated by intensive chemotherapy, two other patients progressed during Azacitidine treatment. WHO performance status III . Two patients had respiratory failure grade 2, the other one suffered from acute kidney insufficiency. Two patients were highly febrile with elevated CRP level. Gemtuzumab ozogamicin administration was performed in three patients followed by further switch to Gemtuzumab ozogamicin + Azacitidine or “7+3” treatment. Results: Gemtuzumab ozogamicin administration resulted in abrupt fever cessation in two febrile patients simultaneously with CRP level decrease and fast gradual resolution of respiratory failure. Recovery of kidney function was noticed in patient with renal insufficiency. WHO performance status have elevated in all three patients. No adverse effects grade II-III were noticed. Further treatment made two patients eligible for intensive chemotherapy, one patient was transplanted, patient with kidney failure obtained complete remission. Conclusions: Gemtuzumab ozogamicin therapy appeared to be safe and highly efficacious in relapsed/refractory AML patients with organ dysfunctions and poor performance status.

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“…Kida et al 42 reported the results of HSCT in a patient who had extramedullary relapse myeloid sarcoma with FLT3-ITD mutation and resistance to chemotherapy; monotherapy with gilteritinib (120 mg/d) resulted in complete remission. Furthermore, cytotoxic T lymphocyte–associated protein 4 inhibitors 43 and CD33 monoclonal antibodies 44 have successfully treated myeloid sarcoma.…”

Section: Discussionmentioning

confidence: 99%

Clinical characteristics, treatment, and prognosis of 118 cases of myeloid sarcoma

Zhao

Dong

Wan

et al. 2022

Sci Rep

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Myeloid sarcoma is a rare manifestation of acute myeloid leukemia (AML) and is associated with poor overall survival (OS). The optimal treatment remains unclear. The study retrospectively evaluated 118 patients with myeloid sarcoma who were treated at the First Affiliated Hospital of Zhengzhou University from January 2010 to July 2021. All cases were diagnosed by tissue biopsy. 41 patients underwent genetic mutation analysis. The most frequent genetic mutations were KIT (16.6%), followed by TET2 (14.6%), and NRAS (14.6%). The median survival time of 118 patients was 4 months (range, 1–51 months), while the median survival time of 11 patients who received allogeneic hematopoietic stem cell transplantation (allo-HSCT) was 19 months (range, 8–51 months). 4 (36.4%) of the 11 patients experienced relapse within 1 year after transplantation. 1 patient died from a severe infection. Of the 6 surviving patients, 5 patients have received maintenance treatment with decitabine after transplantation, and all remained in a state of recurrence-free survival. Patients with myeloid sarcoma have a very unfavorable outcome. Allo-HSCT is an effective treatment option. Recurrence remains the main cause of transplant failure. Maintenance treatment with decitabine after transplantation can prolong the recurrence-free survival time, although these results must be verified in a study with expanded sample size.

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Clinical and Radiographic Response of Extramedullary Leukemia in Patients Treated With Gemtuzumab Ozogamicin

Cited by 10 publications

References 19 publications

Rapid Efficacy of Gemtuzumab Ozogamicin in Refractory AML Patients with Pulmonary and Kidney Failure

Rapid Efficacy of Gemtuzumab Ozogamicin in Refractory AML Patients with Pulmonary and Kidney Failure

Rapid Efficacy of Gemtuzumab Ozogamicin in Refractory AML Patients with Organ Dysfunctions

Clinical characteristics, treatment, and prognosis of 118 cases of myeloid sarcoma

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