AML and Mylotarg

[Linda E.]

Hi. I have been a member of this group for a while, but, never posted.
My mother, who is 78, was diagnosed with MDS, reab, about one year ago. She was showing symptoms for years (low platelet counts), but, tested negative for mds until last April.

She went through a 6-month round of Vidaza and saw some improvement as her platelets were staying at/around 30,000 for the past 6 months. They had previously been as low as 5,000. She suffered from many side effects from the Vidaza as she has a lot of other medical issues.

She has been in the hospital for most of the past 3 weeks, d/t pneumonia and low wbc. (as low as .5; currently at 1.0) Had a bmb on Friday and yesterday, we got the diagnosis that she has progressed to AML.

She is not likely to survive the traditional chemo regimen. Her doctor is contemplating using Mylotarg, which is usually reserved for someone having a first recurrence, after remission from the traditional chemo. We are meeting with him again this evening. Is anyone familiar with Mylotarg, it's side effects and success/failure rate?

Thanks, in advance, for any information that you may have.

Linda E.

[Neil Cuadra]

Hi Linda.

Here is some basic information about Mylotarg:

Mylotarg is the tradename for gemtuzumab ozogamicin. It's given to patients with the CD33 antigen. Do you know if your mother's blood cells have been examined to see if she has the CD33 receptor?

It's a fairly new drug (approved in 2000 for AML treatment), so there aren't likely to be many statistics available. An FDA report titled Approval summary: gemtuzumab ozogamicin in relapsed acute myeloid leukemia discussed a study of 142 patients where the response rate was 26% among patients over age 60, but that report is over 5 years old and was for AML patients, not specifically those with MDS. Protocols for administration and success rates can change from year to year as doctors look for the ideal way to use the drug, so I don't think that report is directly applicable to your mother's case.

This description of Mylotarg at cancer.org from 2004 is easy to understand and lists possible side effects.

There is a large trial (about 2000 patients) in progress to study Mylotarg's use in combination with chemo drugs for patients with MDS.

What did the doctor say this evening?

[Linda E.]

Thanks for the response, Neil. The doctor wants to go ahead with it and my mother agrees that we 'need to try something.' It is that or nothing at this point. He did give us the 25% chance of remission.... and side effects: 25% of liver problems.... high fever... decreased counts, etc.,... He is going to wait until Monday to administer the drug as he is not on call this weekend and wants to be available. He also said he wouldn't give her the full dose, but, a 3/4 dose? It is administered twice, with two weeks in between. He is going to bring some articles for us from some physician websites. He did mention that there haven't been a lot of studies in patients with mds, but, that it is an option for patients unable to receive the traditional chemo.

I meant to ask about chromosomes, but, completely forgot! I will ask. Her classification of aml is M2.

Linda E.