Two cases of mediastinal gray zone lymphoma.

Mediastinal gray zone lymphoma (MGZL) represents a range of tumors possessing characteristics of both nodular sclerosis classical Hodgkin lymphoma (NSHL) and mediastinal large B-cell lymphoma (MLBCL). Here we report two patients with MGZL. Patient 1 was a 30-year-old woman and patient 2 was a 22-year-old man. Both patients had a mediastinal mass, were initially diagnosed with NSHL and exhibited resistance to first-line chemotherapy. Re-biopsy of the relapsed tumors or the residual lesion was performed and based on the findings the tumors were diagnosed as MGZL. In patient 1, the morphological features of the tumor resembled those of NSHL, but the immunophenotypic features indicated MLBCL. In patient 2, the tumor was a composite lymphoma with both NSHL and MLBCL components. Both the patients received high-dose chemotherapy followed by autologous peripheral-blood stem-cell transplantation. Although there is an overlap in the biological and morphological features between NSHL and MLBCL, the therapeutic approaches to NSHL and MLBCL are quite different. The development of effective therapies for MGZL is therefore extremely critical.

Fractionated administration of gemtuzumab ozogamicin for refractory acute myeloid leukemia.

It is difficult to decide an appropriate treatment strategy for elderly leukemia patients with other complications. We encountered 2 cases of refractory acute myeloid leukemia and safely treated the patients with fractionated administration of gemtuzumab ozogamicin (GO). Standard induction therapies were not effective for these patients. Moreover, they suffered from complications due to which their treatment options were restricted. Fractionated administration of GO (GO 3 mg/m(2) on days 1, 3 and 5) was accomplished safely and alleviated the patients' conditions. After treatment, these patients were followed by outpatient basis. We consider that this is an impressive treatment because fractionated administration of GO is potentially less toxic. Further, it will be helpful to maintain or improve the QOL of patients who are unable to receive intensive chemotherapy. These cases were significant because fractionated GO treatment is potentially less toxic and it will be helpful to maintain or improve the QOL of patients who can not receive intensive chemotherapy.

Gemtuzumab ozogamicin (GO) in relapsed/refractory patients with acute myeloid leukemia.

OBJECTIVE: Gemtuzumab ozogamicin (GO) is a humanized anti-CD33 antibody, linked to calicheamicin, which has been approved in Japan recently. We conducted to evaluate the efficacy and toxicity of GO in our patients with relapsed or refractory AML retrospectively. PATIENTS AND METHODS: Data were collected between March 1, 2000, and March 1, 2006, on 10 patients with relapsed or refractory AML(excluding FAB: M3). Scheduled treatment was two doses of GO monotherapy, 14-28 days apart. RESULTS: Of the 10 assessable patients, two patients achieved CR. CR duration of one patient lasted for 52 months with post-remission treatment. Grade 4 neutropenia occurred in 9 patients, and the incidence of grade 3 or 4 thrombocytopenia was 100%, with no severe bleeding events. Two patients developed infusion-related adverse events that included grade 3 allergic reaction with shock status. Liver damage (grade 3 or 4) were observed in 40% of patients after GO treatment. No patient developed hepatic veno-occlusive disease including 2 patients who underwent HSCT. CONCLUSION: GO is a valuable new treatment option for relapsed or refractory AML patients, however, the benefit from single agent appears insufficient. On going clinical trials including combination with other antileukemic agents might better define the role of GO.