Chowdhury Saeeda, Seropian Stuart, Marks Peter W
Am J Hematol. 2009 Sep;84(9):599-600. doi: 10.1002/ajh.21478.
Salvage chemotherapy for patients with relapsed or refractory acute myeloid leukemia (AML) is generally associated with a low-response rate and significant nonhematologic toxicity. Both decitabine and gemtuzumab ozogamicin have activity in AML as single agents and can be administered sequentially with potential synergy due to their toxicity profiles. Twelve patients with AML, who had received a median of three prior regimens (range 1-6), were treated with decitabine 20 mg/m(2) on days 1 through 5 followed by gemtuzumab ozogamicin 3 mg/m(2) on days 6, 9, and 12. Five patients achieved a complete response (42%) and subsequently underwent hematopoietic stem cell transplantation. Three patients are in complete remission and four are still alive 7 to 16 months after treatment. The regimen was well tolerated with the primary nonhematologic toxicity of Grade 1 or 2 transaminitis observed in four patients. These results indicate that decitabine in combination with gemtuzumab is a regimen of promising efficacy worthy of further investigation in controlled trials.
对于复发或难治性急性髓系白血病（AML）患者，挽救性化疗通常反应率较低且伴有显著的非血液学毒性。地西他滨和吉妥珠单抗奥唑米星作为单药在AML治疗中均有活性，由于它们的毒性特征，可序贯给药并具有潜在协同作用。12例AML患者，之前接受的治疗方案中位数为3个（范围1 - 6个），在第1至5天接受20 mg/m²的地西他滨治疗，随后在第6、9和12天接受3 mg/m²的吉妥珠单抗奥唑米星治疗。5例患者获得完全缓解（42%），随后接受了造血干细胞移植。3例患者处于完全缓解状态，4例患者在治疗后7至16个月仍存活。该方案耐受性良好，4例患者出现1或2级转氨酶升高的主要非血液学毒性。这些结果表明，地西他滨联合吉妥珠单抗是一种疗效有望的方案，值得在对照试验中进一步研究。
