What is Tositumomab
The tositumomab therapeutic regimen uses radioimmunotherapy in a 2-step approach that combines a radionuclide and monoclonal antibody for the treatment of non-Hodgkin’s lymphoma (NHL).
Tositumomab is a murine IgG2a gamma monoclonal anti-CD20 antibody. The CD20 antigen (human B-lymphocyte-restricted differentiation antigen, Bp-35) is a hydrophobic transmembrane protein located on normal and malignant pre-B and mature B lymphocytes and established B-cell lines.
The CD20 antigen is expressed on > 90% of B-cell NHL but is not found on other hematopoietic stem cells, pro-B cells, normal plasma cells, or other normal tissues. Iodine I-131 tositumomab is a radio-iodinated derivative of tositumomab that has been covalently linked to iodine I-131.
Tositumomab was FDA-approved in June 2003. However, it was withdrawn from the market in the United States and Canada by the manufacturer (GlaxoSmithKline) in February 2014 due to declining sales.
Brand Name
Bexxar
Indications
- non-Hodgkin’s lymphoma (NHL)
- stem cell transplant preparation
Side Effects
- abdominal pain
- anaphylactoid reactions
- anemia
- angioedema
- anorexia
- antibody formation
- arthralgia
- asthenia
- back pain
- bleeding
- bronchospasm
- chest pain (unspecified)
- chills
- constipation
- cough
- diaphoresis
- diarrhea
- dizziness
- drowsiness
- dyspepsia
- dyspnea
- fever
- headache
- hyperhidrosis
- hypotension
- hypothyroidism
- infection
- infusion-related reactions
- injection site reaction
- myalgia
- nausea
- neutropenia
- new primary malignancy
- paresis
- peripheral edema
- peripheral vasodilation
- pharyngitis
- pruritus
- rash
- rhinitis
- serum sickness
- thrombocytopenia
- vomiting
- weight loss
Monitoring Parameters
- CBC with differential
- serum creatinine
- thyroid function tests (TFTs)
Contraindications
- accidental exposure
- anticoagulant therapy
- bone marrow suppression
- breast-feeding
- chemotherapy
- children
- coagulopathy
- dental disease
- dental work
- fungal infection
- geriatric
- herpes infection
- hypothyroidism
- infection
- infertility
- intramuscular injections
- iodine hypersensitivity
- male-mediated teratogenicity
- neutropenia
- pregnancy
- radiation exposure
- renal failure
- renal impairment
- requires an experienced clinician
- thrombocytopenia
- thyroid disease
- urinary tract obstruction
- vaccination
- varicella
- viral infection
Interactions
- Alpha interferons
- Amlodipine; Celecoxib
- Antithymocyte Globulin
- Azelastine; Fluticasone
- Beclomethasone
- Betamethasone
- Budesonide
- Budesonide; Formoterol
- Celecoxib
- Ciclesonide
- Clozapine
- Corticosteroids
- Corticotropin, ACTH
- Cortisone
- Deflazacort
- Dexamethasone
- Diclofenac
- Diclofenac; Misoprostol
- Diflunisal
- Digoxin
- Diphenhydramine; Ibuprofen
- Diphenhydramine; Naproxen
- Echinacea
- Esomeprazole; Naproxen
- Etodolac
- Famotidine; Ibuprofen
- Fenoprofen
- Filgrastim, G-CSF
- Fludrocortisone
- Flunisolide
- Flurbiprofen
- Fluticasone
- Fluticasone; Salmeterol
- Fluticasone; Umeclidinium; Vilanterol
- Fluticasone; Vilanterol
- Formoterol; Mometasone
- Hydrocodone; Ibuprofen
- Hydrocortisone
- Ibuprofen
- Ibuprofen; Oxycodone
- Ibuprofen; Pseudoephedrine
- Indomethacin
- Interferon Alfa-2a
- Interferon Alfa-2b
- Interferon Alfa-2b; Ribavirin
- Interferon Alfa-n3
- Interferon Alfacon-1
- Ketoprofen
- Ketorolac
- Lansoprazole; Naproxen
- Live Vaccines
- Meclofenamate Sodium
- Mefenamic Acid
- Meloxicam
- Methylprednisolone
- Mometasone
- Nabumetone
- Naproxen
- Naproxen; Pseudoephedrine
- Naproxen; Sumatriptan
- Nonsteroidal antiinflammatory drugs
- Oxaprozin
- Palifermin
- Pegfilgrastim
- Peginterferon Alfa-2a
- Peginterferon Alfa-2b
- Penicillamine
- Piroxicam
- Prednisolone
- Prednisone
- Rofecoxib
- Sulindac
- Tbo-Filgrastim
- Tolmetin
- Triamcinolone
- Tuberculin Purified Protein Derivative, PPD
- Valdecoxib
