High response rate for treatment with gemtuzumab ozogamicin and cytarabine in elderly patients with acute myeloid leukemia and favorable and intermediate-I cytogenetic risk

Sigal Tavor, Einam Rahamim, Nadav Sarid, Uri Rozovski, Lili Gibstein, Freddy Aviv, Ilya Kirsner, Elizabeth Naparstek

Research output: Contribution to journalArticlepeer-review

Abstract

Background: The benefit of gemtuzumab ozogamicin (GO) in combination with chemotherapy as frontline therapy in patients with acute myeloid leukemia (AML) is still debated. Patients and Methods: We evaluated the safety and efficacy of low-dose GO with cytarabine in elderly patients with newly diagnosed AML. Over the past 5 years, we have treated 16 elderly patients with AML (64-82 years) with GO (3 mg/m2) followed by continuous infusion of cytarabine (100 mg/m2) for 7 days. Results: Complete remission (CR) was achieved in 68.8% of patients; however, this was true only in patients in the favorable or intermediate-I cytogenetic risk groups. Of the 12 patients with AML in the favorable and intermediate-I genetic groups, 11 (91.7%) achieved CR. By comparison, of all 4 patients in the intermediate-II or adverse genetic groups, none of the patients achieved CR (P =.003). The median disease-free survival and overall survival (OS) was 10.9 and 18.8 months, respectively, for patients who achieved CR. The estimated median survival was 15 months in the favorable and intermediate-I cytogenetic groups and only 4.4 months in the intermediate-II and unfavorable risk groups (P =.008). The toxicity profile was also manageable in patients with AML who were mainly older than 70 years with good performance status (PS). The 8-week mortality rate was 6.25%, which is relatively low in this high-risk group of patients. These data are in line with results from 2 randomized trials suggesting that the addition of low-dose GO should be further investigated to reevaluate its role in selected elderly patients with AML and raises the issue of the optimal protocol.

Original languageEnglish
Pages (from-to)438-443
Number of pages6
JournalClinical Lymphoma, Myeloma and Leukemia
Volume12
Issue number6
DOIs
StatePublished - Dec 2012

Keywords

  • Acute myeloid leukemia (AML)
  • Cytogenetic analysis
  • Elderly
  • Gemtuzumab ozogamicin

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