Veno-occlusive Disease Risk in Pediatric Patients with Acute Myeloid Leukemia Treated with Gemtuzumab Ozogamicin Before Allogeneic Hematopoietic Cell Transplantation

Overview

Journal Pediatr Blood Cancer

Specialties Hematology
Oncology
Pediatrics

Date 2021 Apr 19

PMID 33871892

Citations 2

Authors

Christine Duncan

Andrew St Martin

Waleska S Perez

Patricia Steinert

Mei-Jie Zhang

Deborah Chirnomas

Caroline J Hoang

Fausto R Loberiza Jr

Wael Saber

Affiliations

Soon will be listed here.

Abstract

Background: Gemtuzumab ozogamicin (GO) administered before allogeneic hematopoietic cell transplantation (alloHCT) has been linked to an increased risk of hepatic veno-occlusive disease/sinusoidal obstruction syndrome (VOD/SOS).

Procedure: This retrospective analysis examined VOD/SOS risk and clinical outcomes in pediatric patients with acute myeloid leukemia who received myeloablative alloHCT in 2008-2011 with (n = 148) and without (n = 348; controls) prior GO exposure and were reported to the Center for International Blood and Marrow Transplant Research.

Results: Cumulative incidences (95% confidence interval [CI]) of VOD/SOS and severe VOD/SOS, respectively, at 100 days were 16% (11-23%) and 8% (4-13%) for GO-exposed patients and 10% (7-13%) and 3% (2-5%) for controls. With a median follow-up of approximately 7 years, the 5-year adjusted overall survival probability (95% CI) after alloHCT was 51% (43-58%) and 55% (50-60%) for GO-exposed patients and controls, respectively; three (4%) and one (<1%) deaths were attributed to VOD/SOS. In multivariate analyses, GO exposure was observed to be associated with an increased risk of VOD/SOS at 100 days, but was not associated with overall survival, disease-free survival, relapse, or nonrelapse mortality.

Conclusions: Results suggest that GO treatment prior to alloHCT in pediatric patients may increase the risk of VOD/SOS but not death.

Citing Articles

Drug-induced hepatic sinusoidal obstruction syndrome: current advances and future perspectives.

Yu Z, Li W, Tian C, Cao Y, Zhang C Arch Toxicol. 2024; 99(3):835-850.

PMID: 39718593 DOI: 10.1007/s00204-024-03950-9.

Inotuzumab ozogamicin in B-cell precursor acute lymphoblastic leukemia: efficacy, toxicity, and practical considerations.

Rubinstein J, OBrien M Front Immunol. 2023; 14:1237738.

PMID: 37600823 PMC: 10435844. DOI: 10.3389/fimmu.2023.1237738.

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