When your doctor tells you or a loved one that you need to get a shot called Blinatumomab to treat leukemia, it's normal to feel a little scared, nervous, and curious. What kind of medicine is this? How does it fight cancer? What do we need to know? I'm writing this description to simply answer a lot of questions like these that you may have in your mind. Let's talk about each of these things one by one.
Simply put, what is Blinatumomab?
Blinatumomab (you'll often find it under the brand name BLINCYTO) is a special medicine that is used to treat leukemia , a type of blood cancer. It's not like a regular chemotherapy medicine. It's a very advanced medicine.
Simply put, this medicine works by talking to your body's own immune system , waking it up, and helping it find and destroy cancer cells. It's like showing our body's defenses the hidden enemies (cancer cells) and telling them, "Here, attack them." In medicine, we call these kinds of drugs monoclonal antibodies . That is, a protein that has been designed to attack only a very specific target.
Things you need to tell your doctor before starting treatment
To give you the best and safest treatment, it's important for your doctor to know your complete health history. So, if any of the following apply to you, be sure to tell your doctor without holding back .
- If you have had radiation therapy to the brain: If you have ever had radiation therapy to an area of your brain before, be sure to mention it.
- Current infections: If you currently have any infection , such as a fever, cough, cold, or urinary tract infection.
- Liver disease: If you have any liver-related condition.
- Nervous system problems: If you have had seizures in the past, if you feel like you are losing your memory, if you have problems such as difficulty speaking, or if you lose your balance when walking.
- If you are scheduled to receive a vaccine: If you are planning to receive any vaccine in the near future.
- Allergies: If you have an allergy to this Blinatumomab medicine or any other medicine, food, or dye.
- If you are trying to get pregnant or are pregnant: This is extremely important if you are pregnant or planning to have a baby. This medicine can cause serious harm to the baby during pregnancy.
- If you are breastfeeding: If you are a mother who is breastfeeding a child.
How can I give you this medicine?
This is not a pill that you swallow. Blinatumomab is a medicine that is injected into a vein . It is usually given to you in a hospital or clinic, under the close supervision of medical staff.
This is not usually a one-time injection. It is given in a small bag (infusion bag) and is given as a saline solution that is slowly infused into your body over a 24-hour period. This way, the treatment can continue for several days.
Before you start each treatment, you will be given a special information leaflet (MedGuide) about this medicine. It is very important to read and understand it carefully each time.
Even small children (from 1 month old) are given this medicine in some special cases. However, the decision is made by a pediatrician.
What if you accidentally take too much medicine?
This is given in a hospital setting, so the chances of this happening are very low. However, if you think you may have taken too much of this medicine, call the National Poisons Information Centre at the Colombo National Hospital immediately . Or, go to the Emergency Treatment Unit (ETU) of the nearest hospital.
What if I miss a treatment session?
It is very important to complete your treatment cycle exactly. Do not miss any treatment sessions for any reason. If for some reason you are unable to come to the hospital on the scheduled day, call your medical team immediately and let them know.
Other medications that may interact with this medicine
It is important to tell your doctor about all the medications you are taking (including vitamins and herbal remedies), as some medications may interact with Blinatumomab.
| Potentially problematic drugs/substances | Simple explanation |
|---|---|
| Live virus vaccines | Avoid getting live virus vaccines (e.g. measles, mumps) while taking this medicine. This medicine changes your immune system, so you may get infections from these vaccines. |
| Cyclosporine | These are also immune-suppressing drugs. Medical advice is required before using these together. |
| Warfarin | If you are taking this medication that prevents blood clotting, its effectiveness may change with Blinatumomab. |
This list is not complete, so tell your doctor about all the medications you are taking.
Things you should be especially careful about during treatment
Your medical team will monitor you closely while you are undergoing this treatment, but it is also important for you to take care of your body.
Be careful about infections.
This medicine may affect the function of your immune system, which may increase your risk of developing infections. Therefore, if you develop symptoms of a cold such as fever, chills, sore throat, and cough , do not self-medicate and inform your medical team immediately. Minimize your visits to places where people are sick.
Blood tests
During treatment, you will need to have regular blood tests (blood work) to check your blood levels.
Driving and operating machinery
This medicine may affect your balance, reaction time, and decision-making ability . Therefore, avoid driving or operating heavy machinery until you know exactly how this medicine affects you. To reduce the risk of dizziness or lightheadedness, stand up quickly, either while sitting or lying down. Drinking alcohol can make these side effects worse.
Pregnancy and breastfeeding (extremely important)
You need to be very careful about this. Getting pregnant while taking this medicine and for 48 hours after the last dose can cause serious birth defects in the baby.
- Before starting treatment, you will be tested to make sure you are not pregnant.
- It is essential to use a reliable form of birth control during the entire treatment period and for 48 hours after treatment. Talk to your doctor about this and choose the most appropriate method.
- Avoid breastfeeding completely while taking this medicine and for 48 hours after the last dose.
What side effects might I experience?
Like any powerful drug, Blinatumomab can cause side effects. Some are serious and should be reported immediately. Others are usually not serious, but if they persist, you should tell your doctor .
| Serious side effects that you should report to your doctor immediately | |
|---|---|
| Allergic reactions | Skin rash, itching, swelling of the face, lips, tongue or throat. |
| Cytokine Release Syndrome | Fever, chills, extreme tiredness, loss of appetite, nausea, headache, dizziness, fainting, difficulty breathing, fast or irregular heartbeat. This may be a strong reaction to the medicine. |
| Infection | Fever, chills, cough, sore throat, non-healing wounds, urinary tract infections, and body aches. |
| Liver injury | Pain in the upper right side of the abdomen, loss of appetite, nausea, light-colored stools, dark yellow or brown urine, yellowing of the skin or eyes, and extreme fatigue. |
| Nervous system problems | Pain in the limbs, numbness, weakness, vision changes, confusion, difficulty speaking, loss of balance, difficulty walking, seizures. |
| Pancreatitis | Severe pain in the upper abdomen, radiating to the back. Pain that worsens when eating or touching the abdomen, fever, nausea, vomiting. |
| Tumor Lysis Syndrome (TLS) | A condition caused by the rapid destruction of cancer cells. Nausea, vomiting, diarrhea, decreased urine output, dark urine, extreme fatigue, confusion, muscle twitching, joint pain, and changes in heart rate. |
| Side effects that are usually not serious, but should be reported to the doctor if they persist | |
| Headache | A general headache may occur. |
| Body swelling | Swelling of the ankles, hands, or feet. |
| Tremors | Uncontrollable shaking of limbs, such as hands and feet. |
This list does not include all possible side effects. If you experience anything unusual or uncomfortable, talk to your doctor about it.
Take-Home Message
- Blinatumomab is a very advanced drug that stimulates your own immune system to fight leukemia.
- Before starting treatment, tell your doctor all your health information, medications you are taking, and any allergies you may have.
- During treatment, be very alert for signs of infection such as fever and cough, and for unusual symptoms related to the nervous system (difficulty speaking, seizures). If you notice anything, tell your doctor immediately.
- Very important: Avoid pregnancy completely during treatment and for 48 hours after treatment. Be sure to use reliable birth control. Also avoid breastfeeding during this time.
- This is not a journey you go through alone. Talk openly with your doctor and medical team about any questions or concerns you may have.
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