Table 7.

Main findings on GO toxicity.

Toxicity Profile
GO has a distinct toxicity profile that requires careful consideration in clinical applications. GO generally exhibits lower extramedullary toxicity compared to traditional treatments for AML relapses.
Hepatic Adverse Effects
Notable adverse effects include the risk of hepatic veno-occlusive disease (HVOD) and sinusoidal obstructive syndrome, particularly in patients with a high tumor burden. The incidence of HVOD after GO therapy at a dose of 9 mg/m2 is reported to be around 5–10% in patients with a high tumor burden. Lower doses of GO combined with chemotherapy are associated with reduced toxicity. The high incidence of hepatotoxicity may be linked to the metabolism of the free drug and damage induced by calicheamicin in the liver’s endothelial sinuosities. Hepatotoxicity may result from the infiltration of leukemic blasts in the liver or damage to CD33-positive Kupffer and sinusoidal cells. Even CD33-negative human hepatocytes can metabolize GO.
Pharmacokinetics
Antibody measurements are effective in representing the pharmacokinetics of GO, with a slow elimination process and a half-life of about 67 h.
Cytotoxicity and Vehicle Function
The IgG4 component of GO is not cytotoxic in vitro and does not induce complement-mediated or antibody-dependent cellular cytotoxicity; it serves as a vehicle to transport the drug.
Toxicity Profile
GO has a distinct toxicity profile that requires careful consideration in clinical applications. GO generally exhibits lower extramedullary toxicity compared to traditional treatments for AML relapses.
Adverse effects of GO include fever, chills, hypotension, skin rash, hypertension, hyperglycemia, dyspnea, nausea, emesis, and headache. Hematological side effects and hepatotoxicity are the most significant toxicities associated with GO. Lower doses of GO combined with chemotherapy are linked to reduced hematological side effects, but thrombocytopenia and neutropenia are consistently observed.
Adverse Effects
Adverse effects of GO include fever, chills, hypotension, skin rash, hypertension, hyperglycemia, dyspnea, nausea, emesis, and headache. Hematological side effects and hepatotoxicity are the most significant toxicities associated with GO. Lower doses of GO combined with chemotherapy are linked to reduced hematological side effects, but thrombocytopenia and neutropenia are consistently observed.
Effect on Myelopoiesis
The effect on myelopoiesis may be due to targeting CD33+ in most differentiated multipotent cells, as pluripotent stem cells do not express CD33.
Monitoring and Management
Monitoring and managing potential complications, including adverse effects, are crucial during GO treatment.