Blinatumomab

Blinatumomab Brand Name– Blincyto

What is Blinatumomab

Blinatumomab is a CD3 T-cell engager that binds to CD19 expressed on the surface of B-cell precursors and to CD3 expressed on the surface of T cells.

It is indicated in adults and pediatric patients for the treatment B-cell precursor acute lymphoblastic leukemia in patients with relapsed or refractory disease or in patients in first or second complete remission who have minimal residual disease of 0.1% or greater.

Cytokine release syndrome (CRS) and neurotoxicity have been reported with blinatumomab therapy; some cases were life-threatening or fatal.

Indications

• acute lymphocytic leukemia (ALL)

Side Effects

1. anaphylactoid reactions
2. anemia
3. anemia
4. angioedema
5. antibody formation
6. aphasia
7. aphasia
8. asthenia
9. atopic dermatitis
10. atrial fibrillation
11. back pain
12. back pain
13. bone pain
14. bradycardia
15. bronchospasm
16. capillary leak syndrome
17. chest pain (unspecified)
18. chills
19. confusion
20. contact dermatitis
21. contact dermatitis
22. cough
23. cranial nerve palsies
24. cytokine release syndrome
25. depression
26. disseminated intravascular coagulation (DIC)
27. dizziness
28. dizziness
29. drowsiness
30. drowsiness
31. dyspnea
32. edema
33. edema
34. elevated hepatic enzymes
35. elevated hepatic enzymes
36. encephalopathy
37. encephalopathy
38. erythema
39. erythema
40. erythema multiforme
41. fever
42. fever
43. fluid retention
44. fluid retention
45. flushing
46. headache
47. headache
48. hyperbilirubinemia
49. hypertension
50. hypertensive crisis
51. hyperthermia
52. hypokalemia
53. hypotension
54. hypotension
55. impaired cognition
56. impaired cognition
57. infection
58. infection
59. infusion-related reactions
60. infusion-related reactions
61. insomnia
62. insomnia
63. lethargy
64. lethargy
65. leukocytosis
66. leukoencephalopathy
67. leukopenia
68. leukopenia
69. lymphadenopathy
70. lymphopenia
71. macrophage activation syndrome
72. maculopapular rash
73. maculopapular rash
74. memory impairment
75. memory impairment
76. myalgia
77. nausea
78. neurotoxicity
79. neurotoxicity
80. neutropenia
81. neutropenia
82. pancreatitis
83. paresis
84. peripheral edema
85. peripheral edema
86. pruritus
87. rash
88. rash
89. seizures
90. sinus tachycardia
91. sinus tachycardia
92. suicidal ideation
93. supraventricular tachycardia (SVT)
94. supraventricular tachycardia (SVT)
95. tachypnea
96. thrombocytopenia
97. thrombocytopenia
98. tremor
99. tremor
100. tumor lysis syndrome (TLS)
101. urticaria
102. weight gain
103. weight gain
104. wheezing

Monitoring Parameters

• CBC with differential
• LFTs
• neurologic function
• pregnancy testing
• serum bilirubin
• serum creatinine
• serum electrolytes
• serum uric acid

Contraindications

• breast-feeding
• capillary leak syndrome
• chemotherapy
• children
• contraception requirements
• cytokine release syndrome
• disseminated intravascular coagulation (DIC)
• driving or operating machinery
• encephalopathy
• geriatric
• hamster protein hypersensitivity
• hepatic disease
• hepatotoxicity
• infants
• infection
• infusion-related reactions
• neonates
• neurological disease
• neurotoxicity
• neutropenia
• pancreatitis
• pregnancy
• pregnancy testing
• radiation therapy
• reproductive risk
• seizures
• sepsis
• tumor lysis syndrome (TLS)
• vaccination

Interactions

• Carbamazepine
• Clozapine
• Cyclosporine
• Dextromethorphan; Quinidine
• Digoxin
• Drospirenone; Ethinyl Estradiol
• Drospirenone; Ethinyl Estradiol; Levomefolate
• Ethinyl Estradiol
• Ethinyl Estradiol; Desogestrel
• Ethinyl Estradiol; Ethynodiol Diacetate
• Ethinyl Estradiol; Etonogestrel
• Ethinyl Estradiol; Levonorgestrel
• Ethinyl Estradiol; Levonorgestrel; Ferrous bisglycinate
• Ethinyl Estradiol; Levonorgestrel; Folic Acid; Levomefolate
• Ethinyl Estradiol; Norelgestromin
• Ethinyl Estradiol; Norethindrone
• Ethinyl Estradiol; Norethindrone Acetate
• Ethinyl Estradiol; Norethindrone Acetate; Ferrous fumarate
• Ethinyl Estradiol; Norethindrone; Ferrous fumarate
• Ethinyl Estradiol; Norgestimate
• Ethinyl Estradiol; Norgestrel
• Ethosuximide
• Flecainide
• Fosphenytoin
• Lithium
• Live Vaccines
• Palifermin
• Penicillamine
• Phenytoin
• Procainamide
• Quinidine
• Segesterone Acetate; Ethinyl Estradiol
• Sirolimus
• Tacrolimus
• Theophylline, Aminophylline
• Tuberculin Purified Protein Derivative, PPD
• Warfarin