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Impact of gemtuzumab ozogamicin consolidation on hematopoietic stem cells (HSCs) mobilization in AML: analysis of 20 patients

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Abstract

Gemtuzumab ozogamicin (GO), is an anti-CD33 monoclonal antibody, approved for AML CD33 + , those patients with low and intermediate-risk who obtain a complete response may also be candidated for consolidation with autologous stem cell transplantation (ASCT). However, there are scant data on the mobilization of hemopoietic stem cells (HSC) after fractionated GO. We retrospectively studied data from five Italian centers and identified 20 patients (median age 54 years, range 29–69, 15 female, 15 NPM1mutated) that attempted HSC mobilization after fractionated doses of GO + “7 + 3” regimen and 1–2 cycles of consolidation (GO + HDAC + daunorubicin). After chemotherapy and standard G-CSF, 11/20 patients (55%) reached the threshold of 20 CD34 + /µL, and HSC were successfully harvested, while 9 patients (45%) failed. The median day of apheresis was Day + 26 from the start of chemotherapy (range 22–39 days). In good mobilizer patients, the median circulating CD34 + cells were 35.9 cells/µL and the median CD34 + harvested were 4.65 × 106/kg of patients’ body weight. With a median follow-up of 12.7 months, at 24 months from the first diagnosis, 93.3% of all 20 patients were alive and the median overall survival was 25 months. The 2-year RFS rate from the timepoint of the first CR was 72.6%, while the median RFS was not reached. However, only five patients underwent ASCT and achieved full engraftment.

In conclusion, in our cohort of patients, the addition of GO reduced HSC mobilization and harvesting, which was reached in about 55% of patients. Nevertheless, further studies are warranted to evaluate the effects of fractionated doses of GO on HSC mobilization and ASCT outcomes.

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Acknowledgements

Paolo Lopedote and Nadezda Zhdanovskaya for critical revising this manuscript.

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Authors and Affiliations

  1. Hematology, Polo Universitario Pontino, “Sapienza”, Via A. Canova S.M. Goretti Hospital, 04100, Latina, Italy

    Salvatore Perrone, Elettra Ortu La Barbera, Maria Cristina Scerpa & Giuseppe Cimino

  2. Haematology, Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy

    Saveria Capria, Silvia Maria Trisolini, Clara Minotti, Maurizio Martelli & Giuseppe Cimino

  3. University Vita-Salute San Raffaele, IRCCS San Raffaele Scientific Institute, Milan, Italy

    Massimo Bernardi & Fabio Ciceri

  4. Hematology and Stem Cell Transplant Unit, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (I.F.O.), Rome, Italy

    Francesco Marchesi

  5. Department of Immunohematology and Transfusional Medicine, AOUP Umberto I, Rome, Italy

    Mahnaz Shafii Bafti

  6. UOC Hematology and Oncology, Ospedali Riuniti Villa Sofia-Cervello, Palermo, Italy

    Antonino Mulé

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  1. Salvatore Perrone
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Perrone, S., Capria, S., Bernardi, M. et al. Impact of gemtuzumab ozogamicin consolidation on hematopoietic stem cells (HSCs) mobilization in AML: analysis of 20 patients. Ann Hematol 102, 769–775 (2023). https://doi.org/10.1007/s00277-023-05129-1

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