An antibody-chemotherapy treatment for a type of leukaemia
Gemtuzumab ozogamicin
An antibody-chemotherapy treatment used for some types of acute myeloid leukaemia, given into a vein.
What is Gemtuzumab ozogamicin?
Gemtuzumab ozogamicin is a specialist cancer treatment used for some types of acute myeloid leukaemia (a cancer of the white blood cells). It is an antibody joined to a powerful chemotherapy drug: the antibody homes in on a marker called CD33 on the leukaemia cells and delivers the chemotherapy straight into them. It is given as a drip into a vein in hospital, usually alongside other chemotherapy. The most important risks are liver damage, including a serious liver problem called veno-occlusive disease, reactions during the infusion, and a drop in blood cells that raises the risk of infection and bleeding. It is used only under close specialist supervision.
Education and reference only. This is a plain-language guide to Gemtuzumab ozogamicin — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Gemtuzumab ozogamicin is a type of treatment called an antibody-drug conjugate, used for some types of acute myeloid leukaemia, a cancer of the blood and bone marrow. It is made of an antibody that recognises a marker called CD33, found on many leukaemia cells, linked to a strong chemotherapy agent. By targeting CD33, it tries to deliver the chemotherapy mainly to the cancer cells. It is given as an infusion into a vein in a specialist cancer unit, often combined with other chemotherapy, and is prescribed and supervised by a haematology team.
How it works
The antibody part of gemtuzumab ozogamicin attaches to CD33, a marker on the surface of many acute myeloid leukaemia cells. Once attached, the whole package is taken inside the cell, where the powerful chemotherapy it carries is released and damages the cell's DNA, killing it. The idea is to concentrate the chemotherapy on the leukaemia cells while sparing healthy cells as much as possible. Because CD33 is also found on some normal blood-forming cells, and the chemotherapy is very potent, it still affects healthy bone marrow and the liver, which is why careful monitoring is needed.
Company & origin
Originated / developed by: Specialist manufacturer.
A specialist treatment used in UK cancer centres for some types of acute myeloid leukaemia, given into a vein.
Practical use
How to take Gemtuzumab ozogamicin
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- It is given as a drip into a vein in a specialist cancer unit, on a schedule planned by your haematology team.
- You will usually be given pre-medication beforehand to lower the chance of a reaction during the infusion.
- Report yellowing of your skin or eyes, a swollen or painful tummy, or sudden weight gain straight away, as these can be signs of liver problems.
- Contact your team urgently if you develop a fever, sore throat, unusual bruising or bleeding, as your blood counts can fall.
- Use reliable contraception during treatment and for as long as your team advises, as it can harm an unborn baby.
Weighing it up
Advantages & disadvantages of Gemtuzumab ozogamicin
Advantages
- Targets a marker on leukaemia cells to help deliver chemotherapy to where it is needed.
- Can improve outcomes for some types of acute myeloid leukaemia when added to other chemotherapy.
- Given as a planned hospital infusion under close specialist care.
Disadvantages
- Can cause serious liver damage, including veno-occlusive disease.
- Lowers blood counts, raising the risk of infection, bruising and bleeding.
- Can cause infusion reactions and, early on, tumour lysis syndrome as cancer cells break down.
Practical use
Good to know
The most important thing to understand about gemtuzumab ozogamicin is its effect on the liver. It can cause serious liver injury, including a condition called veno-occlusive disease (also known as sinusoidal obstruction syndrome), in which small blood vessels in the liver become blocked; signs such as yellowing of the skin or eyes, a swollen or painful tummy, or sudden weight gain should be reported urgently. Reactions during or shortly after the infusion are common, so it is usually given with pre-medication and close watching. Because it lowers blood counts, infections, bruising and bleeding are real risks, and any fever must be reported straight away. As the leukaemia cells break down quickly, a problem called tumour lysis syndrome can occur early on, so fluids and blood tests are used to manage it. Like other cancer treatments of this kind, it can harm an unborn baby, so reliable contraception is essential during treatment and for a time afterwards.
Who should not take it / use with caution
- People who have had a serious allergic reaction to gemtuzumab ozogamicin should not have it.
- It is generally avoided in pregnancy and while breastfeeding because it can harm the baby.
- It is used with great caution, or avoided, in people with significant liver problems, and only under specialist supervision.
Monitoring
- Regular blood tests to check blood counts and liver function.
- Watching closely for signs of veno-occlusive disease and other liver problems.
- Monitoring for infusion reactions, infections and tumour lysis syndrome, especially early in treatment.
Side effects
- A fall in blood cells, leading to infections, tiredness, bruising or bleeding.
- Liver problems, including, seriously, veno-occlusive disease, which needs urgent attention.
- Reactions during the infusion, such as fever, chills, a rash or breathlessness.
- Nausea, mouth soreness, and early on a risk of tumour lysis syndrome as cancer cells break down.
Key interactions
- Other treatments that affect the liver may add to the risk of liver injury, so your team reviews everything you take.
- Other medicines that lower blood counts can deepen the drop in blood cells.
- Tell your team about all your medicines, including anything from a pharmacy or herbal products.
Available as: A powder made up into a solution and given as an infusion into a vein.
Answers
Gemtuzumab ozogamicin: frequently asked questions
What is gemtuzumab ozogamicin used for?
It is used for some types of acute myeloid leukaemia, a cancer of the blood, by targeting a marker called CD33 on the leukaemia cells to deliver chemotherapy into them.
Why does it affect the liver?
It can damage the liver, including causing a serious condition called veno-occlusive disease where small liver blood vessels become blocked, so your liver is closely monitored throughout treatment.
How is it given?
It is given as a drip into a vein in a specialist cancer unit, usually with pre-medication and often alongside other chemotherapy.
Why am I more likely to get infections?
It lowers your blood counts, including the cells that fight infection, so any fever or sign of infection must be reported to your team straight away.
Can I have it during pregnancy?
No. It can harm an unborn baby, so it is avoided in pregnancy and reliable contraception is needed during treatment and for a time afterwards.
Authoritative sources
- BNF
- NICE CKS
Building a medicines information resource?
We create evidence-led, dose-free drug and formulary references for teams.