Abstract：
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.
摘要：
Gemtuzumabozogamicin（GO）是目前用于治疗骨髓恶性肿瘤的CD33单克隆抗体-药物偶联物。该药物的独特副作用是CD33阳性巨噬细胞的破坏,导致游离血红蛋白的清除减少,从而导致大致红色的血浆。游离血红蛋白的这种积累可能导致最终器官损伤并阻止临床上必要的实验室评估的进行。我们介绍了一例儿科患者，该患者出现了这种不良反应，并通过治疗性血浆置换（TPE）成功治疗。我们还提供了来自医学文献的系统回顾的结果，并分享了来自美国食品和药物管理局（FDA）不良事件报告系统的GO相关血红蛋白清除损害的查询数据。在报告的案件中，接受TPE和接受类固醇治疗的患者结局改善.从业者应该意识到这种罕见的药物副作用以及TPE对这些患者的潜在效用。
