Analysis of Predisposing Factors for Hepatic Veno-Occlusive Disease after Treatment with Gemtuzumab Ozogamicin (Mylotargr, CMA-676).
Reviewer: William Levin, MD
The Abramson Cancer Center of the University of Pennsylvania
Last Modified: December 8, 2001
Presenter: Edward Stadtmauer
University of Pennsylvania Cancer Center
- Hepatic veno-occlusive disease (VOD) occurs frequently after hematopoietic stem cell transplantation (HSCT) but is rarely seen with other forms of therapy.
- Gemtuzumab Ozogamicin is a monoclonal anti-CD33 antibody that is used in the treatment of Acute Myeloid Leukemia.
Materials and Methods
- Of 188 patients treated with gemtuzumab for relapsed AML in phase II studies, 4 developed hepatic VOD.
- In the current study Investigators attempt to identify those factors that predispose patients to hepatic VOD.
- A 2% incidence of hepatic VOD was seen in 188 patients treated with gemtuzumab for relapsed AML.
- No correlation was found between the occurrence of VOD and age, gender, baseline bilirubin levels, prior chemotherapeutic regimens, or administration of concomitant medications.
- Only prior autologous hematopoetic stem cell transplant was a risk factor for the development of hepatic VOD, but the correlation was a weak one (p=0.0384)
- Efforts must continue to be made in order to identify factors associated with hepatic VOD.
- Patients with a history of liver disease, elevated liver enzymes, and history of bone marrow transplant should be evaluated closely when considering them for gemtuzumab therapy.
- This abstract illustrates the importance of clinical study in the evaluation of new medications.
- The excitement over the emergence of new cancer therapies must be tempered by the continued monitoring for both acute and long term side-effects of these treatments.