Fractionated Gemtuzumab Ozogamicin in Treating Measurable Residual Disease in Participants With Acute Myeloid Leukemia

Participants receive gemtuzumab ozogamicin intravenously (IV) on days 1, 4, 7. Treatment
continues for 35 days in the absence of disease progression or unacceptable toxicity.
Non-responders without significant adverse events during the first course and responders, may
receive a second course of gemtuzumab ozogamicin within 60 days after course 1.

After completion of study treatment, participants are followed up for 6 months.

Inclusion Criteria:

- Prior diagnosis of AML based on 2016 World Health Organization criteria.

- Patients must have MRD-level disease only and otherwise meet criteria for complete
response (CR) or complete remission with incomplete hematologic recovery (CRi) per the
2017 European Leukemia Net response criteria (< 5% blasts in the marrow without a
requirement for peripheral blood count recovery). MRD must be measurable by
multiparameter flow cytometry (MPFC) and/or polymerase chain reaction (PCR)-based
molecular markers and/or karyotypic markers (e.g., classical cytogenetics or
fluorescence in situ hybridization). MRD status will be centrally confirmed by the
UW/FHCRC clinical laboratory in order to standardize response assessment following
administration of study therapy.

- Patients must have received at least 1 cycle of standard induction chemotherapy prior
to enrollment on the study. However, adult patients (>= 18 years of age) are eligible
for participation at any time point in treatment (after induction, during or after
consolidation, pre-transplant, or post-transplant). Pediatric patients (2-18 years of
age) must have MRD positivity during/after consolidation or post-transplant.

- Eastern Cooperative Oncology Group (ECOG) performance status =< 3 (for adults) or
Lansky performance status >= 40 (for children).

- Patient's AML blasts must have CD33 expression.

- For adults (>= 18 years of age): Serum creatinine =< 2.0 mg/dL.

- For adults (>= 18 years of age): Total bilirubin =< 2 x institutional upper limit of
normal for age (unless known history of Gilbert's disease).

- For adults (>= 18 years of age): Aspartate aminotransferase (AST) and alanine
aminotransferase (ALT) < 2.5 x institutional upper limit of normal for age (unless
thought to be related to resolving infectious complications).

- For children (< 18 years of age): Glomerular filtration rate (GFR) in ml/min (age 2:
63-175; age 3-12: 89-165; females 13 and older: 75-115; males 13 and older: 85-125).

- For children (< 18 years of age): Total bilirubin =< 2 x institutional upper limit of
normal for age (unless known history of Gilbert's disease).

- For children (< 18 years of age): AST and ALT < 2.5 x institutional upper limit of
normal for age (unless thought to be related to resolving infectious complications).

- Ability of patient or representative to provide written informed consent.

- Females of childbearing potential must have a negative pregnancy test prior to
receiving GO.

Exclusion Criteria:

- Subjects who have had chemotherapy or radiation therapy within 14 days prior to
entering the study.

- Subjects may not be receiving other investigational agents.

- Uncontrolled or concurrent illness including, but not limited to, uncontrolled
infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac
arrhythmia, or psychiatric illness/social situations that would limit compliance with
study requirements.