With the increased use of gemtuzumab in induction chemotherapy for children with acute myeloid leukemia, would you change conditioning regimens to help prevent sinusoidal obstruction syndrome during hematopoietic stem cell transplant?  

The current use of Mylotarg uses lower doses of Gemtuzumab and also fewer doses (only in induction-1 in the current COG-AAML1831 clinical trial) which should be at least 2-3 months away from BMT and that's why we do not see a higher SOS rate, but more prospective studies will be needed to answer if ...

The dose and the time to starting conditioning matters.   It has the same efficacy at a lower dose (3 mg) and is tolerated well with very little SOS risk. SOS has to be monitored very closely, however, as there will always be some that will develop it.    Timing matters too. Give...