Gemtuzumab ozogamicin with cytarabine and mitoxantrone as a third-line treatment in a poor prognosis group of adult acute myeloid leukemia patients: a single-center experience |
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Authors: | G Specchia D Pastore P Carluccio G Spinosa M Giannoccaro R Rizzi A Mestice V Liso |
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Institution: | (1) Hematology Section, DAP, University of Bari, Piazza G. Cesare 11, 70124 Bari, Italy |
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Abstract: | We analyzed the safety and efficacy of gemtuzumab ozogamicin (GO) combined with cytarabine and mitoxantrone in the treatment
of 21 patients with acute myeloid leukemia (11 refractory and 10 in second relapse). Patients’ median age was 52 years (range
36–68); all patients had previously been treated with anthracycline-containing regimens (daunorubicin and idarubicin). GO
at a dosage of 3 mg/m2 was administered as a 2-h intravenous infusion on days 1 and 14, cytarabine at 100 mg/m2 on days 1–7, and mitoxantrone at 12 mg/m2 on days 1–3. Infusion-related events were observed in 15 of 21 (71.4%) patients. The incidence of grade 1 or 2 elevations
of bilirubin and hepatic transaminases was 4 of 21 (19%) and 3 of 21 (14.2%). In response to chemotherapy, 2 of 21 (9.5%)
achieved complete remission and 2 of 21 (9.5%) achieved complete remission with incomplete platelet recovery, with an overall
remission rate of 4 of 21(19%); median survival of these 4 patients was 7 months. Four of 21 patients (19%) died during aplasia
after chemotherapy; no veno-occlusive disease occurred. No treatment-related cardiotoxicity or cerebellar toxicity was observed.
In our experience, the addition of GO to mitoxantrone and cytarabine is feasible in refractory or second relapse acute myeloid
leukemia patients but yields a low response rate when used as a third-line treatment. |
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Keywords: | Acute myeloid leukemia Refractory Relapsed Gemtuzumab ozogamicin |
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