What Blinatumomab is and what it is used for?
- Blinatumomab is a bispecific T-cell receptor-engaging (BiTE) antibody that binds to CD19 expressed on B cells and CD3 expressed on T cells. CD19 is found on the surface of B-cell leukemias. This medicine works by directing T cells to target and destroy leukemia cells that have the CD19 on their surface.
- Blinatumomab is used to treat patients with B-cell precursor acute lymphoblastic leukemia (ALL) whose cancer have come back or did not respond to previous treatment.
How Blinatumomab is given?
- It is given as a continuous infusion into a vein over 28 days.
What should I know while receiving Blinatumomab?
- Infusion reactions may happen during or shortly after the infusion, causing fever and chills, flushing, breathing difficulties, chest pain and a drop in blood pressure. Tell your nurse right away if you feel unwell during an infusion.
- Do not use blinatumomab when you are pregnant. Men and women should use effective contraception during treatment and for at least 48 hours after the last dose.
- Do not breastfeed during treatment and for at least 48 hours after the last treatment.
- Do not receive any kind of vaccination without doctor's approval.
- There are many drugs may affect how blinatumomab works. Tell your doctor about all the medicines you are taking, including prescription and non-prescription medicines, vitamins, and herbal supplements.
- You will have regular blood tests to check that you have enough blood cells and have adequate organ functions to receive this medicine. The timing of your treatment may be changed based on the test results or other side effects.
- The existing health problems may affect the use of blinatumomab. You should let your doctor know if you have any other medical problems, especially if you have liver or nervous system problems.
Common side effects
Most fevers are caused by infections. Infections can sometimes be life threatening and need to be treated at once.
- Low platelet count
You may have a higher risk of bleeding. Let your doctor know if you find red or purple dots on the skin, bleeding from the nose or gums, or any bruising or bleeding that you cannot explain.
- Low red blood cell count
You may look pale and get tired more easily. Let your doctor know if you experience any difficulty breathing or dizziness when changing positions.
- Low white blood cell count
You may have a higher risk of getting infections. Try to stay away from crowds and wash hands often. Tell your doctor right away if you have repeated fevers, coughing, stuffy nose, a painful urination or wound that becomes red and swollen.
Tell your doctor if this happens. Be sure to ask your doctor before taking any pain relievers.
Less common side effects
- Elevated liver enzymes
This means your liver is not working well. Common signs and symptoms include weakness, fatigue, poor appetite, yellowing of the skin or eyes, dark urine, or pain in abdomen. Your doctor will monitor you closely during treatment and might stop your treatment if needed.
- Inflammation of pancreas
This is a serious and potential fatal side effect for blinatumomab. Seek medical help at once if you have severe upper abdominal pain that does not go away. This pain may feel worse after eating and may happen with or without nausea and vomiting.
Serious side effects
- Cytokine release syndrome (CRS)
CRS occurs when immune cells are activated by blinatumomab and release large amounts of cytokines into the body. High levels of cytokines may cause inflammation throughout the body. This can interfere with body functions and can be fatal. CRS can present with a variety of symptoms, including fever, fatigue, loss of appetite, muscle and joint pain, nausea, vomiting, diarrhea, rashes, fast breathing, rapid heartbeat, low blood pressure, seizures, headache, confusion, tremor, and loss of coordination. Your doctor will monitor you closely and may prescribe medicines to prevent its development. If your symptoms are severe, your doctor may stop the treatment.
- Tumor lysis syndrome (TLS)
TLS happens when the tumor cells die too quickly and their wastes release into the blood stream. It may cause sudden death if not treated. Symptoms of TLS include general fatigue, muscle cramps, abnormal heartbeat, decreased urination, vomiting, or confusion. Your doctor will monitor you closely and prescribe medicines to prevent its development.
- Neurological Toxicity
Blinatumomab may affect the brain and nervous system. The symptoms can present as confusion, difficulty in speaking, memory loss, seizures, loss of balance, difficulty sleeping, behavior changes, or even loss of consciousness. Your doctor will monitor you closely and may give you medications to help prevent or control these problems. If your symptoms are severe, your doctor may stop the treatment.
- Drink at least 6 to 8 glasses of water every day can help make your recovery a smoother process.
- Alcohol and cigarettes may interfere with certain medicines or worsen side effects from chemotherapy treatment. It is wise to avoid alcohol and cigarette smoking during cancer treatment. If you have any problem about drinking alcohol and smoking, you should check with your doctor.