Description: Antineoplastic Agent, Anti-CD19/CD3
“Alert: Black Box Warning
Cytokine Release Syndrome (CRS), which may be life-threatening or fatal, occurred in patients receiving blinatumomab. Interrupt or discontinue Blinatumomab, Blincyto and treat with corticosteroids as recommended.
Neurotoxicity which may be severe, life-threatening, or fatal, occurred in patients receiving Blinatumomab, Blincyto.
CSA NA – FDA Approved – REMS (Y) – Cannot Ship To US
How Does It Work
Blinatumomab, Blincyto binds to CD19 expressed on B-cells and CD3 expressed on T-cells. The activation of endogenous T cells by connecting CD3 in the T-cell receptor complex with CD19 on B-cells (malignant and benign), thus forming a cytolytic synapse between a cytotoxic T-cell and the cancer target B-cell. Blinatumomab, Blincyto mediates the production of cytolytic proteins, the release of inflammatory cytokines, and proliferation of T cells, which result in lysis of CD19-positive cells.
Indications For Use
Acute lymphoblastic leukemia
Before starting Blinatumomab, Blincyto makes sure your physician is aware of any allergies or medications you currently take. Blinatumomab, Blincyto use has been associated with bone marrow suppression, cytokine release syndrome, hepatotoxicity, infection, leukoencephalopathy, neurotoxicity, pancreatitis, and tumor lysis syndrome. Patients on Blinatumomab, Blincyto should not receive live virus vaccines for at least 2 weeks prior to initiation, during, and after treatment.
Each induction or consolidation treatment cycle consists of 4 weeks of continuous infusion followed by a 2-week treatment-free interval (allow at least 2 weeks treatment-free between cycles)
Pharmacist Tips On Using
Intravenous (24- to 48-hour infusion): Administer 240 mL as a continuous IV infusion at a constant flow rate of 10 mL/hour for 24 hours or 5 mL/hour for 48 hours (depending on dose, duration, and/or concentration) through a dedicated lumen. Use a programmable, lockable, non-elastomeric infusion pump with an alarm. IV tubing should include a sterile, nonpyrogenic, low protein-binding, 0.2-micron in-line filter.
Intravenous (7-day infusion): Administer 100 mL as a continuous IV infusion at a constant flow rate of 0.6 mL/hour for 7 days through a dedicated lumen. Use a programmable, lockable, non-elastomeric infusion pump with an alarm. Do not use an in-line filter for the 7-day infusion bag.
Only use polyolefin, non-di-ethylhexylphthalate PVC, or ethyl vinyl acetate infusion bags, pump cassettes, and IV tubing. IV tubing should be primed with a final prepared solution for infusion and not with NS. Premedication is required prior to some doses. The infusion bag contains overfill (to account for tubing priming volume). Discard unused infusion solution after completion of the infusion. Do not flush infusion line, particularly when changing infusion bags or at the completion of infusion; may result in excess dosage and complications. Do not infuse other medications through the same line.
Edema, hypotension, cardiac arrhythmia, neurotoxicity, headache, chills, insomnia, aphasia, skin rash, hematologic disturbances (i.e. neutropenia, anemia, thrombocytopenia, leukopenia), elevated liver enzymes, infection, tremor, back pain, pneumonia, cough, fever, and infusion-related reactions.
Note this is not a complete list of side effects for Blinatumomab, Blincyto only common ones.
Frequently Asked Questions
Why would my physician prescribe a medication with such serious side effects?
Your physician takes the most recent clinical guidelines to make evidence-based decisions on what medication is appropriate in which situations. Your current medications, your allergies, age, cost of medication, comorbid conditions and many other factors will further complicate or limit which medications are appropriate. This medication is used for certain forms of cancer and your physician has determined the benefits outweigh the risks. Furthermore, they will be monitoring your bloodwork and symptoms closely to avoid many of the serious side effects and will keep you on the lowest effective dosage for the shortest amount of time possible.