Document Type
Article
Publication Date
4-2019
Identifier
DOI: 10.1038/s41375-018-0265-z; PMCID: PMC6438769
Abstract
Although inotuzumab ozogamicin (InO) is recognized as an effective agent in relapsed acute lymphoblastic leukemia (ALL) in adults, data on safety and efficacy in pediatric patients are scarce. We report the use of InO in 51 children with relapsed/refractory ALL treated in the compassionate use program. In this heavily pretreated cohort, complete remission was achieved in 67% of patients with overt marrow disease. The majority (71%) of responders were negative for minimal residual disease. Responses were observed irrespective of cytogenetic subtype or number or type of prior treatment regimens. InO was well-tolerated; grade 3 hepatic transaminitis or hyperbilirubinemia were noted in 6 (12%) and grade 3/4 infections in 11 (22%) patients. No patient developed sinusoidal obstruction syndrome (SOS) during InO therapy; however, 11 of 21 (52%) patients who underwent hematopoietic stem cell transplantation (HSCT) following InO developed SOS. Downregulation of surface CD22 was detected as a possible escape mechanism in three patients who developed a subsequent relapse after InO. We conclude that InO is a well-tolerated, effective therapy for children with relapsed ALL and prospective studies are warranted. Identification of risk factors for developing post-HSCT SOS and strategies to mitigate this risk are ongoing.
Journal Title
Leukemia : official journal of the Leukemia Society of America, Leukemia Research Fund, U.K
Volume
33
Issue
4
First Page
884
Last Page
892
MeSH Keywords
Adolescent; Adult; Antibodies, Monoclonal, Humanized; Antineoplastic Agents; Child; Child, Preschool; Drug Resistance, Neoplasm; Female; Humans; Inotuzumab Ozogamicin; Male; Neoplasm Recurrence, Local; Precursor B-Cell Lymphoblastic Leukemia-Lymphoma; Prognosis; Remission Induction; Retrospective Studies; Salvage Therapy; Survival Rate; Young Adult
Keywords
Adolescent; Adult; Antibodies, Monoclonal, Humanized; Antineoplastic Agents; Child; Child, Preschool; Drug Resistance, Neoplasm; Female; Humans; Inotuzumab Ozogamicin; Male; Neoplasm Recurrence, Local; Precursor B-Cell Lymphoblastic Leukemia-Lymphoma; Prognosis; Remission Induction; Retrospective Studies; Salvage Therapy; Survival Rate; Young Adult
Recommended Citation
Bhojwani D, Sposto R, Shah NN, et al. Inotuzumab ozogamicin in pediatric patients with relapsed/refractory acute lymphoblastic leukemia [published correction appears in Leukemia. 2019 Mar 7;:]. Leukemia. 2019;33(4):884-892. doi:10.1038/s41375-018-0265-z
Comments
Erratum in
Grant support
This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.
Publisher's Link: https://www.nature.com/articles/s41375-018-0265-z