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Gemtuzumab ozogamicin as postconsolidation therapy does not prevent relapse in children with AML: results from NOPHO-AML 2004.

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Authors
Hasle, Henrik
Abrahamsson, Jonas
Forestier, Erik
Ha, Shau-Yin
Heldrup, Jesper
Jahnukainen, Kirsi
Jónsson, Ólafur Gísli
Lausen, Birgitte
Palle, Josefine
Zeller, Bernward
Issue Date
2012-08-02

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Citation
Blood 2012, 120(5):978-84
Abstract
There are no data on the role of postconsolidation therapy with gemtuzumab ozogamicin (GO; Mylotarg) in children with acute myeloid leukemia (AML). The NOPHO-AML 2004 protocol studied postconsolidation randomization to GO or no further therapy. GO was administered at 5 mg/m(2) and repeated after 3 weeks. We randomized 120 patients; 59 to receive GO. Survival was analyzed on an intention-to-treat basis. The median follow-up for patients who were alive was 4.2 years. Children who received GO showed modest elevation of transaminase and bilirubin without signs of veno-occlusive disease. Severe neutropenia followed 95% and febrile neutropenia 40% of the GO courses. Only a moderate decline in platelet count and a minor decrease in hemoglobin occurred. Relapse occurred in 24 and 25 of those randomized to GO or no further therapy. The median time to relapse was 16 months versus 10 months (nonsignificant). The 5-year event-free survival and overall survival was 55% versus 51% and 74% versus 80% in those randomized to receive GO or no further therapy, respectively. Results were similar in all subgroups. In conclusion, GO therapy postconsolidation as given in this trial was well tolerated, showed a nonsignificant delay in time to relapse, but did not change the rate of relapse or survival (clinicaltrials.gov identifier NCT00476541).
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http://dx.doi.org/10.1182/blood-2012-03-416701
http://bloodjournal.hematologylibrary.org/content/120/5/978.full.pdf+html
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ae974a485f413a2113503eed53cd6c53
10.1182/blood-2012-03-416701
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