Blinatumomab is used to treat acute lymphoblastic leukaemia (cancer of the blood where you have too many white blood cells). It is used for those whose disease has returned after responding to treatment or has failed to respond to other treatments.
It is also used in those patients who still have a small number of cancer cells remaining after previous treatment (also known as minimal residual disease).
Blinatumomab injection is to be given intravenously (into the vein) as an infusion. It is delivered directly into the bloodstream via the blood vessel.
You may need to receive your injection in the hospital or clinic under the supervision of your doctor or nurse. Your doctor will discuss with you if you can continue treatment at home after your initial stay at the hospital or clinic.
Your doctor or nurse will administer the injection for you.
Before the Blinatumomab is administered, you may be given other medicines to prevent or lessen the side effects of this medicine.
The dose of this medicine will be decided by your doctor. Your doctor will advise you on the course of treatment depending on the type and severity of your condition, and your response to the medication.
Ensure that you keep all appointments with your doctor so that you do not miss any doses. Your doctor also needs to regularly monitor your response to Blinatumomab.
If you miss an appointment or miss an injection, alert your doctor or nurse. A replacement appointment or injection should be given as soon as possible.
Do not breastfeed while you are being treated with Blinatumomab.
Inform your doctor if you have the following conditions:
- have history of stroke
- kidney disease
- liver disease
- Parkinson's disease (a disorder that affects the movement of a person, causing symptoms such as tremors, muscle stiffness, slowed movement and impaired balance or walking)
- severe brain injury
- epilepsy (fits or seizures)
- active infection
- other symptoms of brain and nerve problems (e.g. shaking or tremor, abnormal sensation, memory loss, confusion)
Let your doctor know if you are pregnant.
It is important that you do not get pregnant while being treated with this medicine. You may wish to discuss birth control methods with your doctor or pharmacist.
Why is it important to keep my appointments with the doctor?
Keep your appointments with your doctor. Your doctor needs to monitor your condition and check your response to the medication regularly.
- Pregnancy tests must be done before treatment to know if this medicine is suited for you to use.
- Routine tests (e.g. complete blood count with differential, liver function) may be done before or while you are being treated with Blinatumomab. Your doctor will advise you about how often you need to have these tests.
- Regular monitoring of signs and symptoms of infection and side effects may also be needed.
Blinatumomab may cause dizziness, drowsiness, coordination, and balance problems. If affected, do not drive or take part in any activity in which you need to be alert.
Other side effects include any of the following: headache, fever, chills, flushing, nausea, vomiting, diarrhoea, weight gain, back pain, and difficulty sleeping.
Some side effects may need immediate medical help. Alert your doctor if you experience any of the following:
- chills, fever, rapid heart rate, coughing, muscle pain, decreased blood pressure as these may be signs of infection
- shaking, tremor, confusion, difficulty in communicating, seizures or convulsion as these may be signs of brain and nerve problems
- fever, swelling, chills, fluid in the lungs as these may be signs of cytokine release syndrome
- severe persistent stomach pain with or without nausea and vomiting as these could be signs of infection of the pancreas
Blinatumomab may cause the level of your red blood cells, white blood cells and platelets to drop.
Red blood cells carry oxygen around your body. A fall in the level of red blood cells may make you feel tired and worn out.
White blood cells help your body to fight infections. A fall in the level of your white blood cells may put you to a higher risk for infections, such as coughs, colds and flu, which may lead to more serious infections. Avoid crowded places and people who are sick. Alert your doctor if you have a fever, or a cough or flu that does not go away.
Platelets help your blood to clot when there is a cut in the skin. A fall in the level of your platelets may put you at risk of bleeding more than usual. Do not take part in activities where you may fall or get injured, such as contact sports. Alert your doctor if you get any unusual bruising (large bruises or several bruises, especially if the bruises appeared on their own) or bleeding that takes a long time to stop (for example, too much bleeding when you floss or brush your teeth).
Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.
Avoid vaccinations with live vaccines during treatment with this medicine. Alert your doctor if you have been recently vaccinated or if you are planning to get vaccinated.
Inform your doctor and pharmacist if you are taking any of these medicines:
- warfarin (blood-thinning medicine)
- ciclosporin (medicine used in organ transplant or certain immune disorders)
This list does not include all medicines that may interact with Blinatumomab.
Always notify your doctor and pharmacist if you are taking any other medicines, including herbal tonics such as traditional Chinese medicines, supplements, and medicines that you buy without a prescription.
Avoid alcohol.
Store in the refrigerator, between 2-8°C. Do not allow to freeze. If frozen, this medicine will become ineffective and should not be used. Protect from light.
If you notice that the injection has changed colour or has become cloudy, do not use it. Throw it away and use a new injection.
Keep in the original packaging to protect from light.
Medicines must not be used past the expiry date.
As Blinatumomab is a cancer medicine, any unused or expired medicine must be returned to the clinic, hospital or pharmacy for disposal. Do not throw it away in the household waste.
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