CD33 expression and P-glycoprotein-mediated drug efflux inversely correlate and predict clinical outcome in patients with acute myeloid leukemia treated with gemtuzumab ozogamicin monotherapy.

Abstract:

:Gemtuzumab ozogamicin (GO) contains an anti-CD33 antibody to facilitate uptake of a toxic calicheamicin-gamma(1) derivative. While recent in vitro data demonstrated a quantitative relationship between CD33 expression and GO cytotoxicity, previous correlative studies failed to identify a significant association between CD33 expression and clinical outcome. Studying patients undergoing GO monotherapy for relapsed acute myeloid leukemia (AML), we now find that AML blasts of responders have a significantly higher mean CD33 level and lower P-glycoprotein (Pgp) activity compared with nonresponders. CD33 expression and Pgp activity are inversely correlated. While both variables are associated with outcome, Pgp remains significantly associated with outcome even after adjusting for CD33, whereas CD33 does not show such an association after adjusting for Pgp. The inverse relationship between CD33 and Pgp suggests a maturation-stage-dependent expression of both proteins, and offers the rationale for using cell differentiation-promoting agents to enhance GO-induced cytotoxicity.

journal_name

Blood

journal_title

Blood

authors

Walter RB,Gooley TA,van der Velden VH,Loken MR,van Dongen JJ,Flowers DA,Bernstein ID,Appelbaum FR

doi

10.1182/blood-2006-09-047399

subject

Has Abstract

pub_date

2007-05-15 00:00:00

pages

4168-70

issue

10

eissn

0006-4971

issn

1528-0020

pii

blood-2006-09-047399

journal_volume

109

pub_type

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