Document Detail


Mylotarg has potent anti-leukaemic effect: a systematic review and meta-analysis of anti-CD33 antibody treatment in acute myeloid leukaemia.
MedLine Citation:
PMID:  25284166     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Conventional chemotherapy is ineffective in the majority of patients with acute myeloid leukaemia (AML), and monoclonal antibodies recognising CD33 expressed on myeloid progenitors (e.g. gemtuzumab ozogamicin (GO)) have been reported to improve outcome in patients with AML. Reports of excess toxicity have resulted in GO's licence being withdrawn. As a result, the role of these agents remains unclear. A systematic review and meta-analysis included studies of patients with AML who had entered a randomised control trial (RCT), where one arm included anti-CD33 antibody therapy. Fixed effect meta-analysis was used, involving calculation of observed minus expected number of events, and variance for each endpoint in each trial, with the overall treatment effect expressed as Peto's odds ratio with 95 % confidence interval. Meta-analysis of 11 RCTs with 13 randomisations involving GO was undertaken. Although GO increased induction deaths (p = 0.02), it led to a reduction in resistant disease (p = 0.0009); hence, there was no improvement in complete remission. Whilst GO improved relapse-free survival (hazard ratio (HR) = 0.90, 95 % confidence interval (CI) = 0.84-0.98, p = 0.01), there was no overall benefit of GO in overall survival (OS) (HR = 0.96, 95 % CI = 0.90-1.02, p = 0.2). GO improved OS in patients with favourable cytogenetics, with no evidence of benefit in patients with intermediate or adverse cytogenetics (test for heterogeneity between subtotals p = 0.01). GO has a potent clinically detectable anti-leukaemic effect. Further trials to investigate its optimum delivery and identification of patient populations who may benefit are needed.
Authors:
J Loke; J N Khan; J S Wilson; C Craddock; K Wheatley
Related Documents :
2228496 - Combined cisplatin and radiation therapy in patients with invasive bladder cancer.
7130416 - Morphometrical analysis of urothelial cells in voided urine of patients with low grade ...
7650666 - Choriocarcinoma of the bladder. report of a case of primary tumor or late metastasis of...
10710246 - A bladder preservation regimen using intra-arterial chemotherapy and radiotherapy for i...
22173716 - A prospective analysis of patient outcome following treatment of t3 rectal cancer with ...
20830766 - Chemoembolization of colorectal liver metastases with cisplatin, doxorubicin, mitomycin...
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-10-5
Journal Detail:
Title:  Annals of hematology     Volume:  -     ISSN:  1432-0584     ISO Abbreviation:  Ann. Hematol.     Publication Date:  2014 Oct 
Date Detail:
Created Date:  2014-10-6     Completed Date:  -     Revised Date:  2014-10-7    
Medline Journal Info:
Nlm Unique ID:  9107334     Medline TA:  Ann Hematol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Potentially Inappropriate Drug Prescribing and Associated Factors in Nursing Homes.
Next Document:  Expanded graphite loaded with lanthanum oxide used as a novel adsorbent for phosphate removal from w...