Hematopoietic stem cell transplant following remission induction chemotherapy including gemtuzumab ozogamicin is a feasible and effective treatment option in elderly patients with acute myeloid leukemia

Abstract

This study analyzed the results of stem cell transplant (SCT) in elderly patients with acute myeloid leukemia (AML) who achieved complete remission (CR) with a gemtuzumab ozogamicin (GO)-containing regimen in order to identify the impact of the drug as a remission induction regimen on the outcome of SCT. Patients who achieved CR with GO proceeded to reduced-intensity conditioning or autologous SCT after one or two cycles of consolidation chemotherapy. With a median follow-up of 53.5 months (n – 17), probabilities of overall survival (OS) and disease-free survival (DFS) at 3 years were 58.2 ± 12.1% and 47.1 ± 12.1%, respectively, and the cumulative incidences of relapse and non-relapse mortality were 35.3 ± 12.1%, and 17.7 ± 9.5%, respectively. Patients with high bone marrow CD33 expression at the time of diagnosis showed significantly higher OS and DFS (70.7%, p = 0.008 and 57.1%, p = 0.008, respectively) than those with low expression. The intensification of post-remission treatment using SCT in elderly patients with AML who achieve CR on GO appears to be an effective and feasible treatment modality.