Chemistry Reference
In-Depth Information
CHAPTER 5
The Genesis of the Antibody
Conjugate Gemtuzumab
Ozogamicin (Mylotarg
s
) for
Acute Myeloid Leukemia
PHILIP R. HAMANN
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Adjunct Professor, John Jay College of Criminal Justice, New York, USA
5.1 Acute Myeloid Leukemia
Although leukemia is commonly thought of as a disease of childhood, there are
leukemias that affect primarily adults, the most common being acute myeloid
leukemia (AML, average patient age 65), which has a US incidence of 2.4 per
100 000.
1
If left untreated, it is routinely fatal in a matter of weeks to months.
2
The initial symptom is usually fatigue, which arises from the replacement of
normal marrow and blood cells by leukemic blasts. This leads to progressive
anemia, neutropenia, and thrombocytopenia, which are associated with infec-
tion and hemorrhage during the course of the disease.
When a patient is strong enough to withstand the side effects, aggressive
chemotherapy is the initial treatment, consisting of multiple rounds of dau-
norubicin and cytosine arabinoside (Ara-C) or similar agents. The common side
effects include nausea, vomiting, hair loss, heart damage, and CNS toxicity.
Remission rates vary from 50 to 80%; unfortunately, 60-80% of patients have a
w
Formerly at Pfizer, 401 N. Middletown Rd., Pearl River, NY 10965, USA.
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