A rare case of fatal hepatic veno-occlusive disease and rupture of the spleen vein and artery after Gemtuzumab Ozogamicin (Mylotarg®) infusion
Document title: A rare case of fatal hepatic veno-occlusive disease and rupture of the spleen vein and artery after Gemtuzumab Ozogamicin (Mylotarg®) infusion
Journal: Revista brasileira de hematologia e hemoterapia
Database: PERIÓDICA
System number: 000305984
ISSN: 1516-8484
Authors: 1
Institutions: 1Hospital Santa Paula, Servico de Onco-Hematologia, Sao Paulo. Brasil
Year:
Volumen: 26
Number: 3
Pages: 218-220
Country: Brasil
Language: Inglés
Document type: Artículo
Approach: Caso clínico
English abstract Gemtuzumab Ozogamicin (Mylotarg®) targets leukemia cells expressing the CD 33 receptor by means of a monoclonal antibody conjugated to a cytotoxic agent, calicheamicin. It was approved for use in elderly patients with relapsed or refractory acute myeloid leukemia and reversible hepatotoxicity is common after administration. The first case of hepatic veno-occlusive disease was reported after Gemtuzumab Ozogamicin infusion in a patient who had been submitted to hematopoietic stem cell transplantation 8 months earlier. Three phase 2 studies with 188 patients with acute myeloid leukemia in first relapse that used Gemtuzumab Ozogamicin were analysed and the incidence of fatal hepatic veno-occlusive disease in these studies was < 1%, and prior hematopoietic stem cell transplantation was the most significant risk factor. The aim of this paper is to report a rare fatal case of hepatic veno-occlusive disease with rupture of the spleen vein and artery in a 68-year-old patient that had received Gemtuzumab Ozogamicin. To the best of our knowledge, it is the first case report of hepatic veno-occlusive disease with rupture of the spleen vein and artery related to Gemtuzumab Ozogamicin
Portuguese abstract Gentuzumab Ozogamicina (GO) (Mylotarg®) tem como alvo células leucêmicas que expressam CD33 através de um anticorpo monoclonal conjugado a um agente citotóxico, a caliqueamicina. Esta droga foi aprovada para uso em pacientes idosos com leucemia mielóide aguda (LMA) recaída ou refratária e hepatotoxicidade é comum após sua administração. Tack e colaboradores apresentaram o primeiro caso de doença hepática veno-oclusiva (DHVO) após infusão de GO em um paciente que tinha realizado transplante de medula( TMO) há 8 meses. Três estudos de fase II com 188 pacientes com LMA foram analisados e a incidência de HVOD fatal foi inferior a 1%, sendo a realização de TMO o fator de risco mais importante. O objetivo deste artigo é relatar um caso raro de DHVO fatal com ruptura de veia e artéria hepática em um paciente de 68 anos que recebeu GO. Acreditamos que este é o primeiro relato de HVOD com ruptura de vasos hepáticos relacionado ao uso de GO
Disciplines: Medicina
Keyword: Farmacología,
Hematología,
Gemtuzumab Ozogamicina,
Enfermedad veno-oclusiva hepática,
Vena hepática,
Arteria hepática
Keyword: Medicine,
Hematology,
Pharmacology,
Gemtuzumab Ozogamicin,
Hepatic veno-occlusive disease,
Hepatic vein,
Hepatic artery
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