Therapeutic plasma exchange as an intervention for gemtuzumab ozogamicin impaired hemoglobin scavenging: A case and systematic review.
Brian David AdkinsDaniel K NolandTamra SloneArhanti SadanandPublished in: Journal of clinical apheresis (2024)
Gemtuzumab ozogamicin (GO) is a CD33 monoclonal antibody-drug conjugate currently in use to treat myeloid malignancies. A unique adverse effect of this medication is destruction of CD33 positive macrophages resulting in reduced clearance of free hemoglobin leading to grossly red plasma. This build-up of free hemoglobin can potentially lead to end organ damage and prevent performance of clinically necessary laboratory evaluation. We present a case of a pediatric patient who developed this adverse effect and was successfully treated with therapeutic plasma exchange (TPE). We also present results from a systematic review of the medical literature and share data from a query of the United States Food and Drug Administration (FDA) Adverse Event Reporting system for GO-related hemoglobin scavenging impairment. Among reported cases, patients undergoing TPE and those receiving steroids had improved outcomes. Practitioners should be aware of this rare drug side-effect and the potential utility of TPE for these patients.
Keyphrases
- systematic review
- adverse drug
- patients undergoing
- acute lymphoblastic leukemia
- end stage renal disease
- drug administration
- healthcare
- red blood cell
- newly diagnosed
- randomized controlled trial
- ejection fraction
- chronic kidney disease
- primary care
- prognostic factors
- oxidative stress
- peritoneal dialysis
- bone marrow
- meta analyses
- emergency department
- dendritic cells
- acute myeloid leukemia
- type diabetes
- metabolic syndrome
- human health
- nk cells
- drug induced
- drug delivery
- big data
- skeletal muscle
- machine learning
- risk assessment
- climate change
- multiple myeloma