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
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