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# Mylotarg (gemtuzumab ozogamicin)
## Overview
Mylotarg is an antibody-drug conjugate that targets CD33, a protein found on the surface of myeloid leukemia cells.
## Primary Indications
* Acute myeloid leukemia (AML) in adults who are newly diagnosed and unfit for intensive induction chemotherapy.
* Relapsed or refractory AML in adults.
## Adult Dosing
* **Newly diagnosed AML unfit for intensive induction chemotherapy:**
* A single dose of 6 mg/m² on day 1.
* A single dose of 3 mg/m² on day 4.
* A single dose of 3 mg/m² on day 7.
* **Relapsed or refractory AML:**
* A single dose of 3 mg/m² on day 1.
* A single dose of 3 mg/m² on day 4.
* A single dose of 3 mg/m² on day 7.
* Repeat cycle every 2-3 weeks.
Dosing depends on patient body surface area. Maximum dose per administration is 6 mg.
## Pediatric Dosing
Dosing in pediatric patients is not established.
## Dose Adjustments
Dose adjustments or interruptions may be necessary for toxicity. Refer to prescribing information for detailed guidance on managing adverse events.
## Contraindications
* Hypersensitivity to gemtuzumab ozogamicin or any of its components.
## Adverse Effects
* **Common:** Febrile neutropenia, thrombocytopenia, nausea, vomiting, diarrhea, fatigue, headache, mucositis, abdominal pain, rash, pyrexia, hypokalemia, elevated liver enzymes.
* **Serious:** Hepatotoxicity (including VOD/SOS), myelosuppression, infusion-related reactions, tumor lysis syndrome. Hepatotoxicity, particularly veno-occlusive disease/sinusoidal obstruction syndrome (VOD/SOS), is a significant concern and can be fatal.
## Key Drug Interactions
* No specific drug interactions have been identified, but caution with other myelosuppressive agents is advised.
## Monitoring
* Complete blood counts (CBC) with differential and platelet counts frequently, especially during and after treatment.
* Liver function tests (LFTs).
* Monitor closely for signs and symptoms of VOD/SOS (e.g., hyperbilirubinemia, hepatomegaly, ascites, weight gain).
* Monitor for infusion-related reactions.
## Clinical Pearls
* The risk of VOD/SOS is significantly higher in patients who have previously undergone stem cell transplantation or have baseline liver dysfunction.
* Infusion-related reactions can occur, so premedication with an antihistamine and corticosteroid may be considered.
* Monitor for tumor lysis syndrome, especially in patients with a high tumor burden.
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*This information is intended for healthcare professionals. Always consult the most current prescribing information for definitive guidance.*
