Shimokawa Takayoshi, Kojima Yumi
Division of Hematology, Nagoya Ekisaikai Hospital.
Gan To Kagaku Ryoho. 2008 Aug;35(8):1427-30.
The efficacy and safety of reinduction therapy with gemtuzumab ozogamicin (GO)were investigated in 7 patients with relapsed or refractory CD33-positive acute myelogeneous leukemia. As the administration method, intravenous drip infusion of 9 mg/m(2) was conducted on day 1 and 15. Though CR was attained in 3 patients, the remaining 4 patients were assessed as PD. Grade 3-4 neutropenia and thrombopenia occurred in all patients, 4 of whom were complicated with febrile neutropenia and 1 with new pneumonia. On the other hand, except for grade 1 digestive symptoms and grade 1 GPT increase, none of the patients had serious complications. Though the treatment with GO is considered comparatively safe, sufficient supportive therapy as in the case of conventional chemotherapy is necessary against hematological toxicity. The effect of monotherapy with GO in reinduction is limited. It is necessary to appropriately select the cases and to investigate an effective administration method including the concomitant use of antitumor agent.
对7例复发或难治性CD33阳性急性髓性白血病患者进行了吉妥珠单抗奥唑米星(GO)再诱导治疗的疗效和安全性研究。给药方法为在第1天和第15天静脉滴注9mg/m²。虽然3例患者达到完全缓解(CR),但其余4例患者评估为疾病进展(PD)。所有患者均出现3-4级中性粒细胞减少和血小板减少,其中4例并发发热性中性粒细胞减少,1例并发新发肺炎。另一方面,除1级消化系统症状和1级谷丙转氨酶升高外,患者均无严重并发症。虽然GO治疗被认为相对安全,但针对血液学毒性,仍需要像传统化疗那样进行充分的支持治疗。GO单药再诱导治疗的效果有限。有必要适当选择病例,并研究包括联合使用抗肿瘤药物在内的有效给药方法。