What role does gemtuzumab ozogamicin have in the treatment of acute myelogenous leukemia?

Gemtuzumab ozogamicin (GO) is a novel, targeted chemotherapy designed to treat acute myeloid leukemia (AML). GO consists of an antitumor antibiotic, calicheamicin, linked to a humanized monoclonal antibody against CD33. It has been approved in the United States since 2000 to treat CD33+ AML in first relapse in older adults who are not candidates for cytotoxic therapy. Beyond this indication, the role of GO is evolving. Single-agent GO has a limited role in de novo AML. Incorporation of GO into standard induction treatment in de novo and relapsed AML is feasible. Comparative phase III studies of such an approach are ongoing. GO is associated with serious toxicities, such as infusional reactions, transient liver function test abnormalities, and veno-occlusive disease of the liver, especially in patients who undergo hematopoietic stem cell transplantation.