A rare case of fatal hepatic veno-occlusive disease and rupture of the spleen vein and artery after Gemtuzumab Ozogamicin (Mylotarg®) infusion

• Published in: Revista brasileira de hematologia e hemoterapia 2004, Vol.26 (3), p.218-220
• Main Authors: Massumoto, Celso M., Pinheiro, Ronald F., Pinheiro Júnior, Edilson D., Baiocchi, Otávio C., Alves, Adelson
• Format: Article
• Language: eng ; por
• Subjects: HEMATOLOGY; MEDICINE, RESEARCH & EXPERIMENTAL
• ISSN: 1516-8484; 1806-0870; 1516-8484
• DOI: 10.1590/S1516-84842004000300013

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.