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Post-Transplant Events

Prior treatment with gemtuzumab ozogamicin and the risk of veno-occlusive disease after allogeneic haematopoietic stem cell transplantation

Bone Marrow Transplantation volume 45, pages 165–170 (2010)Cite this article

Abstract

This was a retrospective multicenter study including 44 acute leukaemia patients who have received allogeneic haematopoietic SCT (allo-HSCT) after prior exposure to Gemtuzumab Ozogamicin (GO) + chemotherapy. Median interval between last administration of GO and allo-HSCT was 4.2 (range, 0.8–26.3) months. At time of allo-HSCT, 33 patients were in CR. The majority of patients (n=36) received a reduced-intensity conditioning (RIC) regimen before allo-HSCT. All but one patient received low-dose heparin for veno-occlusive disease (VOD) prophylaxis. With a median follow-up of 15 (range, 1.1–63) months, overall survival and disease-free survival after allo-HSCT were 45% (95% confidence interval (CI), 30–61%) and 38% (95% CI, 24–54%) at 2 years, respectively. The cumulative incidence of grade 3–4 hyperbilirubinemia was 13.5% (n=6), with this being 21% in patients with a short (⩽3.5 months) GO-allo-HSCT interval (n=4/19) vs 8% in all others (P=NS). Overall, the cumulative incidence of VOD was 7% (n=3), with this being 10.5% (n=2/19) in patients with a short GO-allograft interval (⩽3.5 months) vs 4% (n=1/25) for all others (P=NS), and 5.5% (n=2/36) in patients receiving an RIC regimen vs 12.5% for the others (n=1/8) (P=NS). These results suggest that GO-based chemotherapy before allo-HSCT is feasible and does not result in an excessive rate of liver toxicity, especially VOD, after allo-HSCT.

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Acknowledgements

We thank the nursing staff for providing excellent care for our patients. We also thank the ‘Région Pays de Loire’, the ‘Association pour la Recherche sur le Cancer (ARC)’, the ‘Fondation de France’, the ‘Fondation contre la Leucémie’, the ‘Agence de Biomédecine’, the ‘Association Cent pour Sang la Vie’ and the ‘Association Laurette Fuguain’ for their generous and continuous support for our clinical and basic research work.

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Author notes

  1. P Chevallier and T Prebet: These authors contributed equally to this work.

Authors and Affiliations

  1. Service d’Hématologie Clinique, CHU Hotel-Dieu, Nantes, Cedex 01, France

    P Chevallier & M Mohty

  2. Département d’Hematologie, Institut Paoli-Calmettes, Marseille, France

    T Prebet & D Blaise

  3. Service d’Hematologie Clinique, CHU de Limoges, France

    P Turlure

  4. Service d’Hematologie Clinique, CHU d’Angers, France

    M Hunault & N Ifrah

  5. Service d’Hématologie Clinique, CHU de Bordeaux, France

    S Vigouroux & N Milpied

  6. Université de Nantes, Faculté de Médecine, Centre Régional de Cancérologie de Nantes-Angers (CRCNA), Nantes, France

    J-L Harousseau

  7. INSERM U892, and Centre d’Investigation Clinique en Cancérologie (CI2C), CHU de Nantes, Nantes, France

    M Mohty

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  1. P Chevallier
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Correspondence to P Chevallier.

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Chevallier, P., Prebet, T., Turlure, P. et al. Prior treatment with gemtuzumab ozogamicin and the risk of veno-occlusive disease after allogeneic haematopoietic stem cell transplantation. Bone Marrow Transplant 45, 165–170 (2010). https://doi.org/10.1038/bmt.2009.153

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