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A drug used to treat B-cell acute lymphoblastic leukemia that is in complete remission (all signs and symptoms of cancer have disappeared after previous treatment). It is also used in patients whose cancer has come back or has not gotten better with other anticancer treatment. Blinatumomab binds to a protein called CD19, which is found on most B cells (a type of white blood cell)

And some types of leukemia cells. It also binds to a protein called CD3, which is found on T cells (a type of white blood cell). This may help the immune system kill cancer cells. Blinatumomab is a type of monoclonal antibody. Also called Blincyto.

Information about Blinatumomab

Blinatumomab is a recombinant mouse derived bispecific monoclonal antibody to the CD3 cell surface antigen found on T lymphocytes and the CD19 site for the targeted (malignant) B lymphocytes.  Blinatumomab is approved for use as a second line treatment of relapsed or refractory B cell precursor related acute lymphoblastic leukemia (ALL). 

Liver safety of Blinatumomab

Blinatumomabis commonly associated with mild-to-moderate serum enzyme and bilirubin elevations during the first cycle of therapy, but it has not been linked to cases of clinically apparent liver injury

Mechanism of action of Blinatumomab

Blinatumomab (blin" a toom' oh mab) is a mouse monoclonal IgG1 antibody that has bispecific reactivity to both the CD3 cell surface antigen that is found on normal T cells and the CD19 antigen that is overexpressed on B cell malignancies.  The monoclonal antibody binds to T cells and brings them into contact with malignant B cells, allowing them to recognize and eliminate ALL blasts.  Blinatumomab has been evaluated in children and adults with relapsed or refractory acute lymphoblastic leukemia (ALL) and shown to induce a high rate of clinical response and to prolong overall survival in comparison to conventional chemotherapy. 

FDA approval information for Blinatumomab

Blinatumomab was approved for use in patients with Philadelphia chromosome-negative, relapsed or refractory, B cell precursor-related ALL in 2014. 

Dosage and administration for Blinatumomab

Blinatumomab is available as a powder for reconstitution in single use vials of 35 µg under the brand name Blincyto.  Blinatumomab is given by constant intravenous infusion in variable daily doses [9 or 28 µg in persons 45 kg or greater] for 28 days per cycle.

Side effects of Blinatumomab

Side effects are common and can be severe, including infusion reactions, chills, fever, nausea, diarrhea, fatigue, dyspnea, cough, bronchitis, pneumonia, skin rash, neutropenia and infections.  Less common, but potentially severe side effects include cutaneous reactions (Stevens Johnson syndrome), tumor lysis syndrome, pancreatitis, neurological toxicities, prolonged neutropenia, thrombocytopenia and anemia.  Because of the potential severity of infusion reactions, premedication with dexamethasone with the initial dose or with dose escalations or reinitiation of therapy is necessary.  Blinatumomab should be administered under close medical observation and hospitalization for the first 9 days of therapy and for 2 days with subsequent cycles is recommended.

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