Singleagent Therapy

Gemtuzumab ozogamicin consists of a humanized anti-CD33 antibody conjugated to a potent chemother-apeutic, calicheamicin. The drug was developed based on the observation that most AML blasts express CD33, while normal stem cells and nonhematopoietic tissue do not. By targeting CD33, an effective, less toxic therapeutic might result. A large trial in patients with AML in first relapse showed that gemtuzumab ozogamicin used as a single agent resulted in complete responses in 26% of patients (approximately half of whom attained a CR with the exception of platelet recovery, or a CRP), and with less toxicity than might be expected with high-dose chemotherapy.35 Based on these results, the drug was approved by the Food and Drug Administration for the treatment of older patients with recurrent AML in which blasts express CD33. Subsequent studies have shown that, in some combinations, gemtuzumab ozogamicin may contribute to the development of veno-occlusive disease of the liver, so that care should be taken in combining this agent.

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