Gemtuzumab Ozogamicin in the Treatment of Critical Patients with Refractory Acute Myeloid Leukemia (3 Case Reports)

AUTOIMMUNE THROMBOCYTOPENIA

DV Zaitsev, LL Girshova, VV Ivanov, IG Budaeva, DV Motorin, RSh Badaev, KV Bogdanov, YuV Mirolyubova, TS Nikulina, KA Zagorodnikova, NA Zhukova, SV Efremova, TV Chitanava, YuA Alekseeva, AY Zaritskey

VA Almazov National Medical Research Center, 2 Akkuratova str., Saint Petersburg, Russian Federation, 197341

For correspondence: Daniil Vladislavovich Zaitsev, 2 Akkuratova str., Saint Petersburg, Russian Federation, 197341; Tel.: +7(981)727-16-74; e-mail: zaicev_daniil@mail.ru

For citation: Zaitsev DV, Girshova LL, Ivanov VV, et al. Gemtuzumab Ozogamicin in the Treatment of Critical Patients with Refractory Acute Myeloid Leukemia (3 Case Reports). Clinical oncohematology. 2020;13(1):67–74 (In Russ).

DOI: 10.21320/2500-2139-2020-13-1-67-74

ABSTRACT

The treatment of refractory acute myeloid leukemia (AML) patients presents considerable challenges. They are often critically ill. The critical conditions of these patients are mainly associated with severe infectious complications resulting in sepsis as well as with the extramedullary lesions with organ dysfunctions. So far, the obtained data demonstrated the successful use of gemtuzumab ozogamicin, the mechanism of which is likely to be based not only on depletion of CD33-positive tumor cells but also on its immunomodulatory effect. The present article focuses on the fast-effect mechanisms of gemtuzumab ozogamicin and deals with clinical experience of successful use of this drug combined with hypomethylating agents in patients with refractory AML whose condition is critical by the time therapy begins. The use of this drug combination results in fast stabilization of health status, recovery of internal organs, and apyrexia with the decreasing systemic inflammatory response within the first days of therapy. All this together with significantly lower blast count in blood and in bone marrow can bring critically ill patients to recovery.

Keywords: acute myeloid leukemia, critically ill patients, gemtuzumab ozogamicin, refractory course.

Received: August 15, 2019

Accepted: December 16, 2019

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