blincyto

Uses

blincyto is an antineoplastic antibody used to treat Philadelphia chromosome-negative relapsed or refractory B-cell precursor acute lymphoblastic leukemia (ALL).

Indicated for the treatment of Philadelphia chromosome-negative relapsed or refractory B-cell precursor acute lymphoblastic leukemia (ALL).

blincyto is also used to associated treatment for these conditions: Precursor B-Lymphoblastic Lymphoma/Leukaemia Refractory, Relapsed B cell precursor Acute lymphoblastic leukemia

How blincyto works

blincyto is a bispecific CD19-directed CD3 T-cell engager that binds to CD19 expressed on the surface of cells of B-lineage origin and CD3 expressed on the surface of T cells. It activates endogenous T cells by connecting CD3 in the T-cell receptor (TCR) complex with CD19 on benign and malignant B cells. blincyto mediates the formation of a synapse between the T cell and the tumor cell, upregulation of cell adhesion molecules, production of cytolytic proteins, release of inflammatory cytokines, and proliferation of T cells, which result in redirected lysis of CD19+ cells.

Toxicity

• Cytokine Release Syndrome (CRS), which may be life-threatening or fatal, occurred in patients receiving blinatumomab. Interrupt or discontinue blinatumomab as recommended.
• Neurological toxicities, which may be severe, life-threatening, or fatal, occurred in patients receiving blinatumomab. Interrupt or discontinue blinatumomab as recommended.
• In patients receiving blinatumomab in clinical trials, serious infections such as sepsis, pneumonia, bacteremia, opportunistic infections, and catheter-site infections were observed in approximately 25% of patients, some of which were life-threatening or fatal.
• Tumor lysis syndrome (TLS), which may be life-threatening or fatal, has been observed in patients.
• Neutropenia and febrile neutropenia, including life-threatening cases, have been observed in patients.
• Treatment with blinatumomab was associated with transient elevations in liver enzymes.
• Cranial magnetic resonance imaging (MRI) changes showing leukoencephalopathy have been observed in patients receiving blinatumomab, especially in patients with prior treatment with cranial irradiation and antileukemic chemotherapy (including systemic high-dose methotrexate or intrathecal cytarabine).

Food Interaction

blincyto Hypertension interaction

[Major] The use of monoclonal antibodies administered via IV infusion may cause serious infusion reactions, including bronchospasm, hypoxia, dyspnea, fluctuations in blood pressure, laryngeal edema and pulmonary edema.

Caution should be taken in patients with a history of cardiopulmonary disease as they may require additional post-infusion medications to manage respiratory complications.

It is recommended to administer required intravenous hydration and premedication with antihistamines, analgesics, and antipyretics before administration.

Monitor closely for signs and symptoms of infusion reactions during and for at least 4 hours following completion of each infusion in a setting where cardiopulmonary resuscitation medication and equipment are available.

Immediately interrupt or permanently discontinue treatment and institute supportive management for severe or prolonged infusion reactions as appropriate.

blincyto Drug Interaction

Unknown: paclitaxel protein-bound, charcoal, nifedipine, amphetamine / dextroamphetamine, multivitamin with minerals, zolpidem, copper gluconate, arginine, levocarnitine, cysteine, lithium, acetaminophen, bioflavonoids, valproic acid, thiamine, cyanocobalamin, pyridoxine, cholecalciferol, phytonadione, menaquinone

blincyto Disease Interaction

Major: infections, vaccination, infusion reactions, tumor lysis syndromeModerate: liver dysfunction, neurologic disorders, neutropenia, pancreatitisMinor: renal impairment

Volume of Distribution

4.52 L, standard deviation 2.89.

Half Life

2.11 hours, standard deviation 1.42.

Clearance

2.92 L/hour, standard deviation 2.83.

Innovators Monograph

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