イマタキ　オサム   Osamu Imataki   今滝　修    所属   川崎医科大学  医学部 臨床医学　検査診断学（病態解析）    職種   准教授
論文種別	症例報告
言語種別	英語
査読の有無	査読あり
表題	Negative Impact of Gemtuzumab Ozogamicin on CD33-Positive Early T-Cell Precursor Acute Lymphoblastic Leukemia: A Case Report.
掲載誌名	正式名：Case reports in oncology 略　 称：Case Rep Oncol ISSNコード：16626575/16626575
掲載区分	国外
巻・号・頁	17(1),pp.256-261
著者・共著者	Osamu Imataki, Haruyuki Fujita, Makiko Uemura
担当区分	筆頭著者
発行年月	2024/02/15
概要	INTRODUCTION:Early T-cell precursor acute lymphoblastic leukemia (ETP-ALL) is a rare subtype of T-cell leukemia that phenotypically expresses mature T-cell markers and immature myeloid markers such as CD33. Gemtuzumab ozogamicin (GO) is a novel agent for the CD33 molecular targeting antibody conjugated to the cytotoxic agent calicheamicin. GO is anticipated to be effective against ETP-ALL. In vivo studies promise antileukemic effects in cell lines; however, clinical reports to support this research are lacking. We treated a patient who suffered from CD33-positive ETP-ALL using GO.CASE PRESENTATION:We treated an 81-year-old man who suffered from ETP-ALL. The patient's leukemia expressed T cell and myeloid markers including cyCD3, CD5, CD7, CD33, and HLA-DR. Initially, the patient was treated using a standard chemotherapy regimen for acute lymphoblastic leukemia comprising cyclophosphamide, daunorubicin, vincristine, l-asparaginase, and prednisolone. The induction chemotherapy produced the expected complete hematological response; however, bone marrow blasts remained. Following consolidation chemotherapy, the patient maintained a full hematological response. Thereafter, we changed the consolidation regimen to nelarabine, which did not reduce bone marrow blasts effectively. After two courses of nelarabine therapy, we finally used GO at an 8 mg/m2 weekly dose after confirming that CD33 expression was still positive in the patient's residual leukemic cells. GO was ineffective in treating the patient's leukemia, and peripheral blasts increased 30 days following treatment. The patient died 81 days after initiating GO therapy.CONCLUSION:This is the first clinical case of GO having a negative impact on ETP-ALL. Because the GO resistance mechanism for ETP-ALL has not been fully elucidated, treatment modification should be considered to achieve optimal clinical efficacy.
DOI	10.1159/000536424
PMID	38362442