Mylotarg (gemtuzumab ozogamicin)治疗与未接受干细胞移植患者的肝静脉闭合性疾病相关。
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Giles FJ, Kantarjian HM, Kornblau SM, Thomas DA, Garcia-Manero G, Waddelow TA, David CL, Phan AT, Colburn DE, Rashid A, Estey EH
Mylotarg (gemtuzumab ozogamicin)治疗与未接受干细胞移植患者的肝静脉闭合性疾病相关。
癌症杂志2001 july 15;92(2):406-13。
- PubMed ID
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11466696 (PubMed视图］
- 摘要
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背景:Mylotarg (Wyeth-Ayerst Laboratories, St. david, PA)是一种calicheamicin偶联的人源化抗cd33单克隆抗体(gemtuzumab ozogamicin, CMA-676)的品牌名称，最近已被批准用于治疗老年复发性急性髓系白血病(AML)患者。Mylotarg与该患者人群中约20%的3级或4级高胆红素血症和肝转氨炎发病率相关。在Mylotarg治疗后接受干细胞移植(SCT)的患者中有肝静脉闭合性疾病(VOD)的报道。在SCT之外，VOD很少与细胞毒性治疗相关。方法:作者评估了119例接受mylotarg -含非sct方案的患者VOD的发生率。VOD是通过使用西雅图和巴尔的摩标准进行诊断的。结果:119例AML(92例)、晚期骨髓增生异常综合征(25例)或慢性髓系白血病(2例)患者(61例既往未治疗，58例复发)接受mylotarg为基础的治疗方案。14家(12%)开发了VOD。2例患者的组织学和10例患者的放射学研究支持VOD的诊断。14例VOD患者中有5例(36%)之前未接受过抗白血病细胞毒治疗，其中2例患者接受了单药Mylotarg治疗。 CONCLUSIONS: Mylotarg was shown to be associated with the development of potentially fatal VOD in patients with leukemia who had not received SCT. VOD occurred when Mylotarg was used either as a single agent or when it was given with other cytotoxic agents. VOD occurred in Mylotarg-treated patients who had received no prior cytotoxic therapy. The current study concluded that risk factors for VOD should be assessed when considering Mylotarg therapy, and that attempts to avoid and treat VOD are warranted in patients who receive Mylotarg therapy.
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