Inotuzumab ozogamicin is effective in relapsed/refractory extramedullary B acute lymphoblastic leukemia 11 Medical and Health Sciences 1112 Oncology and Carcinogenesis 11 Medical and Health Sciences 1102 Cardiorespiratory Medicine and Haematology

Luca Bertamini, Jacopo Nanni, Giovanni Marconi, Mariachiara Abbenante, Valentina Robustelli, Francesco Bacci, Antonella Matti, Stefania Paolini, Chiara Sartor, Silvia Lo Monaco, Maria Chiara Fontana, Stefano De Polo, Michele Cavo, Antonio Curti, Giovanni Martinelli, Cristina Papayannidis

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: Extramedullary involvement of B-cell Acute Lymphoblastic Leukemia (EM-ALL) is a rare occurrence, characterized by dismal outcome and the absence of a defined and shared therapeutic approach. In the landscape of innovative compounds, inotuzumab ozogamicin (IO) is a promising drug, whose mechanism of action relies on the killing of CD22 positive leukemic cells, through the delivery, after cell binding, of a molecule of calicheamicin. Case presentation: We report two cases of CD22 positive relapsed EM-ALL treated with IO, obtained as compassionate use. Case 1, a 66 years old woman, affected by Philadelphia (Ph) negative B-ALL, relapsed with extramedullary involvement after 6 standard chemotherapy courses, who reached a complete metabolic response with IO treatment. Case 2, a 67 years old man with Ph positive B-ALL, initially treated with ponatinib, a third generation tyrosine-kinase inhibitor (TKI), obtaining a prolonged deep molecular remission. Nevertheless, for skin relapse during TKI treatment, the patient received local radiotherapy and, shortly after, standard chemotherapy, as multiple abdominal sites of relapse were detected too, with no response. The patient then received IO, obtained as compassionate use, with a good metabolic response. Conclusions: These two cases suggest a possible key role of IO in the setting of advanced CD22 positive ALL, and underline its potential activity also in patients with EM involvement, relapsed after or refractory to conventional chemotherapy. Despite the well known hepatotoxic effect of the compound (Sinusoid Occlusive Syndrome), neither of them had such adverse event, moreover the second patient safely underwent allogeneic bone marrow transplantation.

Original languageEnglish
Article number1117
JournalBMC Cancer
Volume18
Issue number1
DOIs
Publication statusPublished - Nov 15 2018

Fingerprint

Hematology
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Carcinogenesis
Medicine
Compassionate Use Trials
Health
Drug Therapy
Protein-Tyrosine Kinases
B-Lymphocytes
Recurrence
Homologous Transplantation
Bone Marrow Transplantation
Radiotherapy
Therapeutics
Inotuzumab Ozogamicin
Skin
Pharmaceutical Preparations

Keywords

  • Acute lymphoblastic leukemia
  • Extramedullary
  • Inotuzumab ozogamicin
  • PET-CT scan

ASJC Scopus subject areas

  • Oncology
  • Genetics
  • Cancer Research

Cite this

Inotuzumab ozogamicin is effective in relapsed/refractory extramedullary B acute lymphoblastic leukemia 11 Medical and Health Sciences 1112 Oncology and Carcinogenesis 11 Medical and Health Sciences 1102 Cardiorespiratory Medicine and Haematology. / Bertamini, Luca; Nanni, Jacopo; Marconi, Giovanni; Abbenante, Mariachiara; Robustelli, Valentina; Bacci, Francesco; Matti, Antonella; Paolini, Stefania; Sartor, Chiara; Monaco, Silvia Lo; Fontana, Maria Chiara; De Polo, Stefano; Cavo, Michele; Curti, Antonio; Martinelli, Giovanni; Papayannidis, Cristina.

In: BMC Cancer, Vol. 18, No. 1, 1117, 15.11.2018.

Research output: Contribution to journalArticle

Bertamini, L, Nanni, J, Marconi, G, Abbenante, M, Robustelli, V, Bacci, F, Matti, A, Paolini, S, Sartor, C, Monaco, SL, Fontana, MC, De Polo, S, Cavo, M, Curti, A, Martinelli, G & Papayannidis, C 2018, 'Inotuzumab ozogamicin is effective in relapsed/refractory extramedullary B acute lymphoblastic leukemia 11 Medical and Health Sciences 1112 Oncology and Carcinogenesis 11 Medical and Health Sciences 1102 Cardiorespiratory Medicine and Haematology', BMC Cancer, vol. 18, no. 1, 1117. https://doi.org/10.1186/s12885-018-5026-x
Bertamini, Luca ; Nanni, Jacopo ; Marconi, Giovanni ; Abbenante, Mariachiara ; Robustelli, Valentina ; Bacci, Francesco ; Matti, Antonella ; Paolini, Stefania ; Sartor, Chiara ; Monaco, Silvia Lo ; Fontana, Maria Chiara ; De Polo, Stefano ; Cavo, Michele ; Curti, Antonio ; Martinelli, Giovanni ; Papayannidis, Cristina. / Inotuzumab ozogamicin is effective in relapsed/refractory extramedullary B acute lymphoblastic leukemia 11 Medical and Health Sciences 1112 Oncology and Carcinogenesis 11 Medical and Health Sciences 1102 Cardiorespiratory Medicine and Haematology. In: BMC Cancer. 2018 ; Vol. 18, No. 1.
@article{2b3905ff96334cdcaf125ea31a60feff,
title = "Inotuzumab ozogamicin is effective in relapsed/refractory extramedullary B acute lymphoblastic leukemia 11 Medical and Health Sciences 1112 Oncology and Carcinogenesis 11 Medical and Health Sciences 1102 Cardiorespiratory Medicine and Haematology",
abstract = "Background: Extramedullary involvement of B-cell Acute Lymphoblastic Leukemia (EM-ALL) is a rare occurrence, characterized by dismal outcome and the absence of a defined and shared therapeutic approach. In the landscape of innovative compounds, inotuzumab ozogamicin (IO) is a promising drug, whose mechanism of action relies on the killing of CD22 positive leukemic cells, through the delivery, after cell binding, of a molecule of calicheamicin. Case presentation: We report two cases of CD22 positive relapsed EM-ALL treated with IO, obtained as compassionate use. Case 1, a 66 years old woman, affected by Philadelphia (Ph) negative B-ALL, relapsed with extramedullary involvement after 6 standard chemotherapy courses, who reached a complete metabolic response with IO treatment. Case 2, a 67 years old man with Ph positive B-ALL, initially treated with ponatinib, a third generation tyrosine-kinase inhibitor (TKI), obtaining a prolonged deep molecular remission. Nevertheless, for skin relapse during TKI treatment, the patient received local radiotherapy and, shortly after, standard chemotherapy, as multiple abdominal sites of relapse were detected too, with no response. The patient then received IO, obtained as compassionate use, with a good metabolic response. Conclusions: These two cases suggest a possible key role of IO in the setting of advanced CD22 positive ALL, and underline its potential activity also in patients with EM involvement, relapsed after or refractory to conventional chemotherapy. Despite the well known hepatotoxic effect of the compound (Sinusoid Occlusive Syndrome), neither of them had such adverse event, moreover the second patient safely underwent allogeneic bone marrow transplantation.",
keywords = "Acute lymphoblastic leukemia, Extramedullary, Inotuzumab ozogamicin, PET-CT scan",
author = "Luca Bertamini and Jacopo Nanni and Giovanni Marconi and Mariachiara Abbenante and Valentina Robustelli and Francesco Bacci and Antonella Matti and Stefania Paolini and Chiara Sartor and Monaco, {Silvia Lo} and Fontana, {Maria Chiara} and {De Polo}, Stefano and Michele Cavo and Antonio Curti and Giovanni Martinelli and Cristina Papayannidis",
year = "2018",
month = "11",
day = "15",
doi = "10.1186/s12885-018-5026-x",
language = "English",
volume = "18",
journal = "BMC Cancer",
issn = "1471-2407",
publisher = "BioMed Central Ltd.",
number = "1",

}

TY - JOUR

T1 - Inotuzumab ozogamicin is effective in relapsed/refractory extramedullary B acute lymphoblastic leukemia 11 Medical and Health Sciences 1112 Oncology and Carcinogenesis 11 Medical and Health Sciences 1102 Cardiorespiratory Medicine and Haematology

AU - Bertamini, Luca

AU - Nanni, Jacopo

AU - Marconi, Giovanni

AU - Abbenante, Mariachiara

AU - Robustelli, Valentina

AU - Bacci, Francesco

AU - Matti, Antonella

AU - Paolini, Stefania

AU - Sartor, Chiara

AU - Monaco, Silvia Lo

AU - Fontana, Maria Chiara

AU - De Polo, Stefano

AU - Cavo, Michele

AU - Curti, Antonio

AU - Martinelli, Giovanni

AU - Papayannidis, Cristina

PY - 2018/11/15

Y1 - 2018/11/15

N2 - Background: Extramedullary involvement of B-cell Acute Lymphoblastic Leukemia (EM-ALL) is a rare occurrence, characterized by dismal outcome and the absence of a defined and shared therapeutic approach. In the landscape of innovative compounds, inotuzumab ozogamicin (IO) is a promising drug, whose mechanism of action relies on the killing of CD22 positive leukemic cells, through the delivery, after cell binding, of a molecule of calicheamicin. Case presentation: We report two cases of CD22 positive relapsed EM-ALL treated with IO, obtained as compassionate use. Case 1, a 66 years old woman, affected by Philadelphia (Ph) negative B-ALL, relapsed with extramedullary involvement after 6 standard chemotherapy courses, who reached a complete metabolic response with IO treatment. Case 2, a 67 years old man with Ph positive B-ALL, initially treated with ponatinib, a third generation tyrosine-kinase inhibitor (TKI), obtaining a prolonged deep molecular remission. Nevertheless, for skin relapse during TKI treatment, the patient received local radiotherapy and, shortly after, standard chemotherapy, as multiple abdominal sites of relapse were detected too, with no response. The patient then received IO, obtained as compassionate use, with a good metabolic response. Conclusions: These two cases suggest a possible key role of IO in the setting of advanced CD22 positive ALL, and underline its potential activity also in patients with EM involvement, relapsed after or refractory to conventional chemotherapy. Despite the well known hepatotoxic effect of the compound (Sinusoid Occlusive Syndrome), neither of them had such adverse event, moreover the second patient safely underwent allogeneic bone marrow transplantation.

AB - Background: Extramedullary involvement of B-cell Acute Lymphoblastic Leukemia (EM-ALL) is a rare occurrence, characterized by dismal outcome and the absence of a defined and shared therapeutic approach. In the landscape of innovative compounds, inotuzumab ozogamicin (IO) is a promising drug, whose mechanism of action relies on the killing of CD22 positive leukemic cells, through the delivery, after cell binding, of a molecule of calicheamicin. Case presentation: We report two cases of CD22 positive relapsed EM-ALL treated with IO, obtained as compassionate use. Case 1, a 66 years old woman, affected by Philadelphia (Ph) negative B-ALL, relapsed with extramedullary involvement after 6 standard chemotherapy courses, who reached a complete metabolic response with IO treatment. Case 2, a 67 years old man with Ph positive B-ALL, initially treated with ponatinib, a third generation tyrosine-kinase inhibitor (TKI), obtaining a prolonged deep molecular remission. Nevertheless, for skin relapse during TKI treatment, the patient received local radiotherapy and, shortly after, standard chemotherapy, as multiple abdominal sites of relapse were detected too, with no response. The patient then received IO, obtained as compassionate use, with a good metabolic response. Conclusions: These two cases suggest a possible key role of IO in the setting of advanced CD22 positive ALL, and underline its potential activity also in patients with EM involvement, relapsed after or refractory to conventional chemotherapy. Despite the well known hepatotoxic effect of the compound (Sinusoid Occlusive Syndrome), neither of them had such adverse event, moreover the second patient safely underwent allogeneic bone marrow transplantation.

KW - Acute lymphoblastic leukemia

KW - Extramedullary

KW - Inotuzumab ozogamicin

KW - PET-CT scan

UR - http://www.scopus.com/inward/record.url?scp=85056631650&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85056631650&partnerID=8YFLogxK

U2 - 10.1186/s12885-018-5026-x

DO - 10.1186/s12885-018-5026-x

M3 - Article

C2 - 30442119

AN - SCOPUS:85056631650

VL - 18

JO - BMC Cancer

JF - BMC Cancer

SN - 1471-2407

IS - 1

M1 - 1117

ER -