Blinatumomab

Blinatumomab treats a certain type of leukemia. Before you receive this medication, you may be given a corticosteroid medicine to help reduce infusion reactions.

Blinatumomab Overview

Reviewed: December 3, 2014
Updated: 

Blinatumomab is a prescription medicine used to treat a certain type of acute lymphoblastic leukemia (ALL). Acute lymphoblastic leukemia is a cancer of the blood in which a particular kind of white blood cell is growing out of control. 

Blinatumomab is a type of immunotherapy, a treatment that uses certain parts of a person’s immune system to destroy leukemia cells.

This medication comes in an injectable form to be given directly into the vein by continuous IV infusion for 4 weeks (28 days), followed by a 2 week break.

Common side effects include fever and headache. Do not drive, operate heavy machinery, or do other dangerous activities while you are receiving blinatumomab as it may cause dizziness, seizures, and confusion.

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Uses of Blinatumomab

Blinatumomab is a prescription medicine used to treat a certain type of acute lymphoblastic leukemia (ALL). Acute lymphoblastic leukemia is a cancer of the blood in which a particular kind of white blood cell is growing out of control. 

Blinatumomab, an immunotherapy, is approved to treat patients with Philadelphia chromosome-negative (Ph-) relapsed or refractory B-cell precursor ALL.

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.

Blinatumomab Brand Names

Blinatumomab may be found in some form under the following brand names:

Blinatumomab Drug Class

Blinatumomab is part of the drug class:

Side Effects of Blinatumomab

The most common side effects of blinatumomab include:

  • fever
  • headache
  • swelling of hands, ankles or feet
  • nausea
  • constipation
  • shaking(tremor)
  • rash

Tell your healthcare provider if you have any side effect that bothers you or that does not go away.

These are not all the possible side of effects of blinatumomab.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Blinatumomab Interactions

Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. Especially tell your healthcare provider if you take:

  • warfarin
  • cyclosporine

This is not a complete list of blinatumomab drug interactions. Ask your doctor or pharmacist for more information.

 

Blinatumomab Precautions

Blinatumomab may cause serious side effects that can be severe, life- threatening, or lead to death, including:

Cytokine Release Syndrome (CRS) and Infusion Reactions. Symptoms of CRS and infusion reactions may include:

  • fever
  • tiredness or weakness
  • dizziness
  • headache
  • low blood pressure
  • nausea
  • vomiting
  • chills
  • face swelling
  • wheezing or trouble breathing skin rash 

Neurologic problems. Symptoms of neurologic problems may include:

  • seizures
  • difficulty in speaking or slurred speech
  • loss of consciousness
  • confusion and disorientation
  • loss of balance

Your healthcare provider will check you for these problems during treatment with blinatumomab. Your healthcare provider may temporarily stop or completely stop your treatment with blinatumomab, if you have severe side effects. 

Do not receive blinatumomab if you are allergic to blinatumomab or to any of the ingredients of blinatumomab. 

Blinatumomab may cause other serious side effects, including:

  • Infections. Blinatumomab may cause life-threatening infections that may lead to death. Tell your healthcare provider right away if you develop an infection.

  • Low white blood cell counts (neutropenia). Neutropenia is common with blinatumomab treatment and may sometimes be life-threatening. Low white blood cell counts can increase your risk of infection. Tell your healthcare provider right away if you get a fever.

  • Abnormal liver blood test. Your healthcare provider will do blood tests before you start Blinatumomab and during treatment with Blinatumomab to check your liver. 

  • Inflammation of the pancreas. Tell your healthcare provider right away if you have severe stomach-area pain that does not go away. The pain may happen with or without nausea and vomiting. 

Blinatumomab Food Interactions

Medicines can interact with certain foods. In some cases this may be harmful and your doctor may advise you to avoid certain foods. In the case of blinatumomab, there are no specific foods that you must exclude from your diet when receiving this medication.

Inform MD

Before you receive blinatumomab, tell your healthcare provider about all of your medical conditions, including if you:

  • are allergic to blinatumomab or to any of its ingredients
  • have a history of neurological problems, such as seizures, confusion, trouble speaking or loss of balance.
  • have an infection.
  • have ever had an infusion reaction after receiving blinatumomab or other medications.
  • are pregnant or plan to become pregnant. blinatumomab may harm your unborn baby. Tell your healthcare provider if you become pregnant during treatment with blinatumomab.
  • are breastfeeding or plan to breastfeed. It is not known if blinatumomab passes into your breast milk. You and your healthcare provider should decide if you will take blinatumomab or breastfeed. You should not do both.

Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. 

 

Blinatumomab and Pregnancy

Tell your healthcare provider if you are pregnant or plan to become pregnant.

The FDA categorizes medications based on safety for use during pregnancy. Five categories - A, B, C, D and X are used to classify the possible risks to an unborn baby when a medication is taken during pregnancy.

This medication falls into category C. No well-controlled studies have been done in humans. Therefore, this medication may be used if the potential benefits to the mother outweigh the potential risks to the unborn child.

Blinatumomab and Lactation

Tell your healthcare provider if you are breastfeeding. It is not known if blinatumomab is excreted in human milk or if it will harm your nursing baby.

Blinatumomab Usage

A treatment course consists of up to 2 cycles of Blincyto for induction followed by 3 additional cycles for consolidation and up to 4 additional cycles of continued therapy.

  • Blinatumomab will be given to you by intravenous (IV) infusion into your vein by an infusion pump.
  • Your healthcare provider will decide the number of treatment cycles of Blincyto. 
    • You will receive blinatumomab by continuous IV infusion for 4 weeks (28 days), followed by a 2 week break during which you will not be given blinatumomab. This is one treatment cycle. After the 2 week break, your healthcare provider will decide if you will be given additional treatment cycles of blinatumomab. (You may receive up to 5 treatment cycles)
  • Your healthcare provider may prescribe continued therapy
    • You will receive blinatumomab by continuous IV infusion for 4 weeks (28 days), followed by an 8 week (56 days) break during which you will not receive Blincyto. You may receive up to 4 treatment cycles of continued therapy.
  • Your healthcare provider may give you blinatumomab in a hospital or clinic for the first 9 days of the first treatment cycle and for the first 2 days of the second cycle to check you for side effects. If you receive additional treatment cycles of blinatumomab or if your treatment is stopped for a period of time and restarted, you may also be treated in a hospital or clinic.
  • Your healthcare provider may change your dose of blinatumomab, delay, or completely stop treatment with blinatumomab if you have certain side effects.
  • Your healthcare provider will do blood tests during treatment with blinatumomab to check you for side effects.
  • Before you receive blinatumomab, you will be given a corticosteroid medicine to help reduce infusion reactions.
  • It is very important to keep the area around the IV catheter clean to reduce the risk of getting an infection. Your healthcare provider will show you how to care for your catheter site.
  • Do not change the settings on your infusion pump, even if there is a problem with your pump or your pump alarm sounds. Call your healthcare provider or nurse right away if you have any problems with your pump or your pump alarm sounds. Any changes to your infusion pump settings may cause a dose that is too high or too low to be given.

Blinatumomab Dosage

The dose will depend on your weight and tolerability of side effects. 

A treatment course consists of up to 2 cycles of blinatumomab for induction followed by 3 additional cycles for consolidation and up to 4 additional cycles of continued therapy.

Blinatumomab Overdose

If an overdose is suspected, seek emergency medical attention.

Other Requirements

 

Blinatumomab FDA Warning

WARNING: CYTOKINE RELEASE SYNDROME and NEUROLOGICAL TOXICITIES

  • Cytokine Release Syndrome (CRS), which may be life-threatening or fatal, occurred in patients receiving BLINCYTO. Interrupt or discontinue BLINCYTO as recommended.

  • Neurological toxicities, which may be severe, life-threatening, or fatal, occurred in patients receiving BLINCYTO. Interrupt or discontinue BLINCYTO as recommended.